Journal of Occupational Rehabilitation最新文献

Purpose: We aimed to develop an online vocational rehabilitation (VR) readiness screening (VRRS) tool for young adults diagnosed with cancer. VR readiness was defined as being physically and cognitively ready to enter or return to work or school.

Methods: We developed an initial VRRS tool informed by previous studies, a scoping review to determine such a tool had not already been developed, and consultation with subject matter experts. We iteratively refined the tool on the basis of four rounds of interviews with young adults with cancer. The refined VRRS was then administered online to patients before they attended scheduled clinic appointments. We evaluated the VRRS completion rate; the ability of the online VRRS tool to assess patients' readiness for VR; and the concordance between clinical interview and that of the online VRRS tool, which was determined by using Cohen's κ or a fitting alternative; κ ≥ .61 suggested clinical utility.

Results: The proportion of study participants completing the VRRS was 72.3% (136/188, 95% CI [65.4%, 78.6%]) and 69.2% (81/117, 95% CI [60.0%, 77.4%]) of participants who completed a clinical interview also completed the online VRRS tool. All clinical interview determinations and 93.8% (76/81) of online VRRS tool indicated participants' VR readiness. The VRRS-clinical interview agreement rate was 93.8% (95% CI [86.2%, 98.0%]). The prevalence index, bias index, and prevalence- and bias-adjusted κ statistic with 95% CIs were 0.938 [- 0.991, - 0.886], 0.062 [0.009, 0.114], and 0.877 [0.724, 0.959], respectively.

Conclusion: The VRRS tool is thus both feasible and effective in this sample of young adults with cancer.

Purpose: This qualitative study investigated the needs, barriers, and facilitators that affect primary care providers' involvement in supporting patients' stay-at-work and return-to-work following injury or illness. It also aims to understand the lived experiences of primary care providers who participated in the Extension for Community Healthcare Outcomes training program for Occupational and Environmental Medicine (ECHO OEM). By examining both the structural and experiential aspects of the program, this study seeks to provide insights into how ECHO OEM influences providers' approaches to occupational health challenges.

Methods: Those who attended ECHO OEM sessions were invited to participate in the research study. Four focus groups and five one-on-one interviews were conducted with healthcare providers participating in ECHO OEM. Audio-recordings were transcribed verbatim and analyzed using an inductive thematic analysis approach. This study was structured according to the COREQ Checklist.

Results: We discussed six main themes: (1) Challenges with Engaging with Workers' Compensation Boards; (2) Return to Work practices; (3) Health and Well-Being; (4) Communication is Important; (5) Perspective from the Workplace; and (6) Feedback on ECHO OEM.

Conclusion: ECHO OEM sessions contribute to and impact healthcare providers' knowledge of supporting injured or ill workers. Topics that deserve further attention include incorporating comorbid physical and mental health conditions, navigating workers' compensation systems, and supporting specific populations such as military veterans and emergency personnel.

Purpose: Evidence shows that patient outcomes following musculoskeletal injury have been associated with the timing of care. Despite the increasing number of injured workers presenting with low back pain (LBP) in primary care, little is known about the factors that are associated with the timing of initial healthcare provider visits. This study investigated factors that are associated with the timing of initial workers' compensation (WC)-funded care provider visits for LBP claims.

Methods: We used a retrospective cohort design. A standardised multi-jurisdiction database of LBP claims with injury dates from July 2011 to June 2015 was analysed. Determinants of the time to initial general practitioner (GPs) and or musculoskeletal (MSK) therapists were investigated using an accelerated failure time model, with a time ratio (TR) > 1 indicating a longer time to initial healthcare provider visit.

Results: 9088 LBP claims were included. The median time to first healthcare provider visit was 3 days (interquartile range (IQR) 1-9). Compared to General practitioners (GPs) (median 3 days, IQR 1-8), the timing of initial consultation was longer if the first healthcare providers were MSK therapists (median 5 days, IQR 2-14) (p < 0.001). Female workers had a shorter time to first healthcare provider visit [TR = 0.87; 95% CI (0.78, 0.97)] compared to males. It took twice as long to see MSK therapists first as it did to see GPs for injured workers [TR = 2.12; 95% CI (1.88, 2.40)]. Professional workers and those from remote areas also experienced delayed initial healthcare provider visits.

Conclusions: The time to initial healthcare provider visit for compensable LBP varied significantly by certain occupational and contextual factors. Further research is needed to investigate the impact of the timing of initial visits to healthcare providers on claim outcomes.

Purpose: Employee sickness absence (SA) is a significant issue facing organizations and individuals worldwide, leading to multiple negative consequences, such as increased costs, early retirement, decreased productivity, and reduced quality of work. Therefore, within the occupational health and safety (OHS) framework, it is crucial to explore the factors that help workforces stay at work sustainably. This study investigates the role of work-related psychosocial factors (WRPFs) as predictors of SA and suggests proactive measures to prevent its occurrence.

Methods: A systematic literature review was conducted within the Job Demands-Resources Model framework. Following the PRISMA Checklist, 1087 articles from PsycINFO, Medline, and Web of Science databases were screened, and 30 longitudinal studies were included.

Results: The findings describe SA as a multifaceted phenomenon influenced by risk (e.g., poor quality leadership, bullying, and violence) and protective WRPFs (e.g., developmental opportunities and social support). These factors, spanning contextual, content-related, and relational dimensions, collectively influence workers' SA over time.

Conclusions: These insights provide valuable guidance for researchers and OHS stakeholders, supporting the development of research and interventions aimed at preventing SA. This research contributes important knowledge to the field, paving the way for more targeted strategies that address the organizational causes of SA and promote healthier, more productive work environments.

Background: Firefighters are routinely exposed to significant work-related musculoskeletal disorders (WRMSDs) which can sometimes be career-ending due to the workplace stressors and the physical demands of the job. Shoulder disorders are the third most frequent WRMSDs that cause pain, disability, and morbidity in the general working population. However, little is known about the task-specific causes and risk factors for work-related shoulder disorders (WSDs) among firefighters (FFs).

Objectives: To explore the perspectives of FFs who experienced WSDs with respect to the following: (a) risk factors of WSDs; and (b) causative factors for WSDs.

Methods: Using an interpretive descriptive methodology, we purposefully sampled for age and occupational diversity. Twelve FFs (males, 8 and females, 4) between 26 and 63 years, who experienced WSDs during their career ranging from 3 to 33 years were recruited. One-on-one interviews based on a semi-structured interview guide were conducted via an online Zoom platform and transcribed verbatim. Transcripts were analyzed using reflexive thematic analysis.

Results: The WSDs reported by FFs included rotator cuff tears, labral tears and muscle sprains or strains. Three themes were identified as risk factors for WSDs: (1) too much or too little shoulder exercises is a risk for shoulder injuries; (2) internal contextual factors can increase the risk of shoulder injurie; and (3) personal factors such as age and sex mediate the risk of shoulder injuries. Three themes were reported by FFs as the causative factors of WSDs: (1) unpredictable hazards in harsh environmental conditions can lead to traumatic shoulder injuries; (2) maneuvering heavy equipment in non-ergonomic positions can lead to shoulder strains; and (3) routine firefighting tasks can lead to gradual onset of shoulder injuries.

Implications: Our results emphasized the inter-related and multifaceted nature of the risks and causative factors that increase the risk of traumatic or gradual onset WSDs among FFs. There is a need for a comprehensive prevention and self-management program that addresses fire-specific prevention and treatment program that addresses modifiable environmental, behavioral and personal risks factors.

Purpose: Workers' compensation claims can negatively affect the wellbeing of injured workers. For some, these negative effects continue beyond finalisation of the workers' compensation claim. It is unclear what factors influence wellbeing following finalisation of a workers' compensation claim. Therefore, the aim of this study was to explore wellbeing through the lived experience of individuals who have finalised a workers' compensation claim in the state of Western Australia.

Methods: A qualitative study with individual, in-depth, semi-structured interviews was performed (n = 20, 55% female, average claim length 22.9 months, average time since claim end 33.4 months). Claim finalisation modes included full medical recovery, claim settlement with permanent impairment, direct settlement with the insurer and settlement with the insurer facilitated by a lawyer. The interview schedule was informed by a previous scoping review and cross-sectional survey completed by this research team. Qualitative data were analysed utilising a reflexive, interpretative phenomenological analysis approach.

Results: Five superordinate and their associated subordinate themes were identified; (1) The role of support; (2) Stigma and discrimination; (3) A new normal; (4) The importance of information; and (5) Recommended resources.

Conclusions: Injured workers experience a range of outcomes related to their wellbeing and employment following the finalisation of their workers' compensation claim. Based on their experiences, resources to facilitate a transition and adjustment to life following a claim have been suggested by injured workers, including information regarding seeking employment, seeking welfare support, educational materials regarding future expectations, and individualised support care packages.

Purpose: Despite evidence of efficacy, the effectiveness of telerehabilitation in real-world clinical settings is still largely unknown. Telerehabilitation requires a substantial transformation of the organization and delivery of traditional services. Considering that a virtual setting can create unique challenges for providing physiotherapy services and given the physical and potential hands-on nature of evidence-based assessments and interventions, it is important to investigate what injured workers think of receiving physiotherapy care via telerehabilitation and to examine if rehabilitation needs are adequately met.

Methods: A qualitative interpretive description study was conducted to explore the perspectives and experiences of 17 injured workers receiving physiotherapy via telerehabilitation. Data were collected through semi-structured interviews with participants from three provinces in Western Canada and analysed using thematic analysis. Qualitative rigour criteria of epistemological integrity, analytic logic, interpretive authority, and representative credibility were considered throughout this study.

Results: Implementation of telerehabilitation during the COVID-19 pandemic resulted in mixed perceptions from injured workers. Some viewed telerehabilitation as a resourceful option for providing services during the pandemic lockdown, resulting in maintained communications while overcoming barriers to services (e.g., rural/remote workers, transportation barriers, etc.). However, many thought telerehabilitation was inferior to in-person therapy for assessment and when 'hands-on' interaction was needed. Many believed a hybrid option may be ideal now that pandemic restrictions are lifted, with telerehabilitation supplementing in-person physiotherapy when needed.

Conclusions: Telerehabilitation was viewed as a resourceful option during the pandemic and in certain clinical situations (e.g., rural/remote). Workers should be able to make informed choices about service delivery format.

Purpose: The objective of this study is twofold: (1) to better understand the Return-to-Work (RTW) process of employees on sick leave due to burnout by evaluating RTW obstacles and self-efficacy to overcome them, and (2) to investigate strategies implemented for maintaining employment following burnout.

Method: Fifty-one participants completed the online questionnaire titled "Return-to-Work Obstacles and Self-Efficacy Scale (ROSES)", and two focus groups were conducted with employees returning to work after experiencing burnout.

Results: All the ROSES dimensions emerged as potential obstacles to returning to work after burnout. Several were particularly challenging to overcome, such as Fears of a relapse, Cognitive difficulties, and Loss of motivation to RTW. Qualitative analysis of verbatim from focus groups identified eight categories of strategies for overcoming these obstacles, such as Work involvement regulation strategies, Identity and anxiety regulation strategies, Seeking care and support from professionals, and Cognitive and metacognitive strategies, among the most often mentioned.

Conclusion: These findings pave the way for a more detailed analysis of the perceived obstacles individuals face during their RTW after burnout. Furthermore, the identification of strategies to overcome these obstacles may prove beneficial not only for the sustainable RTW of individuals, but also for the professionals who support them.

Purpose: The present study adds to the literature by evaluating the differential risk of ADHD symptom dimensions and executive functioning (EF; time management, organization, motivation) to key occupational outcomes.

Methods: Participants were adults (N = 100; 51% male) with ADHD working full-time between the ages of 19-30 (M = 26.61, SD = 2.28). Participants reported on their ADHD symptoms and EF as well as on five areas of occupational functioning (income, written warnings, boredom at work, satisfaction with coworkers and supervisors).

Results: Over and above medication status, sex, and age, path analyses revealed hyperactivity/impulsivity and time management were the most consistent predictors of outcomes. Higher levels of each predictor were associated with lower income, more written warnings, greater boredom at work, as well as lower satisfaction with coworkers and supervisors. Executive function difficulties with organization and motivation were risk factors for all evaluated outcomes, except written warnings. Higher levels of inattention symptoms were associated with more written warnings and lower satisfaction with coworkers.

Conclusion: The present study is one of the first to document the differential risks of ADHD symptoms and EF to a comprehensive set of occupational functioning outcomes. Future research is needed to replicate the present findings and expand this line of work to identify factors that may protect against these ADHD-related risks on workplace success.