Journal of Occupational Rehabilitation最新文献

Purpose: We aimed to evaluate factors associated with performance-related pain among musicians with different backgrounds, comparing music students and professional musicians.

Methods: We performed a multicenter cross-sectional study in a stratified random sample consisting of music students (294) and professional musicians (291). The main outcome was performance-related pain (PRP), measured by the Performance-related Pain among Musicians Questionnaire (PPAM). Factors associated with the outcome were measured using PPAM, International Physical Activity Questionnaire, Modified Fatigue Impact Scale, 10-item Kessler Psychological Distress Scale, Frost Multidimensional Perfectionism Scale, and Medical Outcomes Study Short Form 36 Health Survey.

Results: From the 585 musicians included (response rate of 82.4%), 322 (55.0%) reported PRP. Professional musicians presented a significantly higher lifetime prevalence of PRP (57.5%, p < 0.001); however, music students reported higher levels of fatigue, anxiety and depression, and lower quality of life. Multivariate logistic regression defined a model with 16 factors significantly associated with higher probability of PRP. Additionally, we describe 25 self-perceived factors reported by musicians as being associated with PRP.

Conclusion: We present the first study thoroughly describing and assessing factors associated with PRP among musicians, using a validated tool, including musicians with different backgrounds, and distinguishing music students and professional musicians. We also explore self-perceived factors associated with PRP. The relevant insights coming from this and future studies on factors associated with PRP will contribute to developing more effective preventive programs and improving evidence-based guidance and management of musicians affected by PRP.

Purpose: This study assessed the effectiveness of Individual Placement and Support (IPS), Participatory Workplace Intervention (PWI), and IPS + PWI on work participation and health of people with work disabilities.

Methods: A randomised controlled 2 × 2 factorial trial with 120 clients and an 18-month follow-up was performed. Differences between IPS and no-IPS and between PWI and no-PWI were assessed using log-rank tests and Cox proportional hazards models.

Results: In the IPS group, restricted mean survival time (RMST) for sustainable paid employment was 352 days, compared to 394 in the no-IPS group (HR = 1.47, 95% CI = 0.81-2.63). In the PWI group the RMST was 378 days, compared to 367 in the no-PWI group (HR = 0.89, 95% CI = 0.48-1.64). For the secondary outcome 'starting any paid employment, a trial placement, or education' RMST was significantly lower for the IPS group (222 days) than for the no-IPS group (335 days; HR = 1.85, 95% CI = 1.01-3.42). Mental health was significantly lower (worse) in the PWI group (difference -4.07, 95% CI = -7.93 to -0.22) than in the no-PWI group. For all other secondary outcomes, no statistically significant differences were found.

Conclusion: No statistically significant differences were observed in the duration until starting sustainable employment between IPS and no-IPS, and between PWI and no-PWI. The duration until starting any paid employment, a trial placement, or education was shorter in the IPS group than in the no-IPS group, but further research should explore whether this also increases sustainable employment in the longer term.

Purpose: Low-back pain (LBP) is a prevalent condition among healthcare workers, negatively affecting well-being and work ability. Research has identified fear-avoidance beliefs, i.e., the belief that physical activities worsen or prolong pain, as a key psychological factor in LBP. Given the physical demands of healthcare work, understanding the link between fear-avoidance and LBP is crucial for effective prevention and management strategies. This study investigated the prospective association between fear-avoidance beliefs and risk of increased LBP intensity and duration in hospital workers.

Methods: Fear-avoidance beliefs and LBP were assessed in 1933 healthcare workers from 389 departments at 19 hospitals at baseline and 1-year follow-up. Associations between baseline work-related fear-avoidance beliefs (FABW) and LBP intensity and duration at follow-up were analyzed using cumulative logistic regression, adjusting for various factors including age, sex, baseline LBP, education, seniority, patient transfers, psychosocial work environment, and lifestyle.

Results: Moderate and high FABW was associated with higher odds of increased pain intensity (OR: 1.37 [95% CI 1.09-1.73] and 1.85 [95% CI 1.18-2.88], respectively) and prolonged pain duration (OR: 1.37 [95% CI 1.05-1.78] and 2.27 [95% CI 1.50-3.44], respectively). A sensitivity analysis including only female nurses showed similar results, with the high FABW group having significantly higher odds of increased pain intensity (OR 2.95, 95% CI 1.84-4.72) and duration (OR 2.64, 95% CI 1.55-4.49).

Conclusions: Fear-avoidance beliefs increase the risk of LBP intensity and duration among healthcare workers, emphasizing the need for interventions dealing with psychological aspects of LBP.

Purpose: The aim was to evaluate the effectiveness of a problem-solving intervention with workplace involvement (PSI-WPI) added to care as usual (CAU) in reducing sickness absence days among employees with common mental disorders compared to CAU alone in Swedish primary health care on a monthly basis over 18-months follow-up.

Methods: We conducted a cluster-randomised controlled trial including 197 employees blinded to allocation (85 PSI-WPI and 112 CAU). As sickness absence data was skewed and over-dispersed, generalised estimating equations was used to enable a comparison between the intervention and control group for each month of the follow-up period.

Results: The median number of sickness absence days over the 18-month follow-up was 78 days, inter-quartile range (IQR) 18-196 for employees receiving PSI-WPI and 64 days, IQR 18-161 for employees receiving CAU. The time x group generalised estimating equations analysis showed no statistically significant difference in sickness absence days per month.

Conclusion: The addition of a PSI-WPI to CAU was not more effective in reducing sickness absence days. This may be explained by the primary health care context, lack of specialisation in occupational health and the Swedish social insurance system with specific time limits.

Trial registration: The trial was registered at ClinicalTrials.gov, identifier: NCT03346395 on January 12th, 2018.

Background: The objectives of this longitudinal study were to understand how comorbid rheumatic disease and depression symptoms were associated with at-work productivity among young adults, and to examine whether workplace support modified this association.

Methods: Seventy-six Canadian young adults who were employed and living with a rheumatic disease were surveyed three times over 27 months. Morbidity was defined by whether participants reported severe rheumatic disease symptoms and/or depressive symptoms. Participants were asked about presenteeism, absenteeism, and whether the workplace support needs (accommodation and benefit availability and use) were met. Generalized estimating equations were used to address study objectives.

Results: Seventeen participants experienced neither severe rheumatic disease nor depressive symptoms (no morbidity), 42 participants experienced either severe rheumatic disease or depressive symptoms (single morbidity), and 17 participants reported comorbidity at baseline. Participants with comorbidity reported greater presenteeism scores and were most likely to report absenteeism, compared to the other two morbidity levels. Having workplace support needs met was associated with decreased presenteeism over the 27-month period among participants with no and a single morbidity. Conversely, unmet support need was associated with greater presenteeism for participants with comorbidity. Having workplace support needs met did not modify the association between morbidity and absenteeism.

Conclusion: Comorbid rheumatic disease and depression burden reduce productivity among young adults. A supportive work environment has the potential to address at-work productivity challenges. Additional research is needed to understand how workplace supports coupled with clinical interventions may tackle challenges at work for young adults living with rheumatic disease and depression.

Purpose: Mental health problems (MHPs) are subjected to workplace stigma and can deteriorate into common mental disorders (CMDs) and sickness absence (SA). Research has shown that personal stigmatizing attitudes limit managers' efforts towards employees with MHPs, but knowledge is lacking regarding stigma in social contexts (contextual stigma) and different types of possible preventive actions. This study investigates personal stigmatizing attitudes and three contextual stigma layers (employee, collegial, organizational) and different types of possible actions to prevent SA of employees with MHPs.

Method: Survey data of 2769 Swedish managers working in the private sector were analysed. Personal stigmatizing attitudes were measured with the managerial stigma towards employee depression scale and supplemented with four additional items capturing contextual stigma. Managers watched video vignettes and assessed which preventive actions (n  = 20) were possible to use in their organization. A sum score was calculated reflecting the 'number of actions'. Principal component analysis revealed three action types: adapt tasks and setting, involve experts, and social support. A score reflecting the 'possibilities to implement actions' was calculated for each type. Multiple linear regression analyses were conducted with the four stigma layers as independent variables for each of the three action variables.

Results: Personal stigmatizing attitudes and contextual stigma were significantly associated with both 'number of actions' and 'possibilities for implementing actions' relating to all action types. Patterns of associations with contextual stigma were significant but varied between the different action types.

Conclusion: This study substantiated the role of personal stigmatizing attitudes and contextual stigma in relation to possible actions of managers to prevent SA of employees with MHPs. The results emphasize the role of contextual stigma. Implications for practice and research are discussed.

Purpose: To identify, appraise, and synthesize qualitative research evidence exploring patients' needs regarding work-focused healthcare.

Methods: A systematic review was conducted in accordance with the PRISMA statement guidelines to identify studies reporting patients' needs regarding work-focused healthcare. Four databases (MEDLINE, Embase, PsychInfo and Web of Science) were systematically searched from January 2000 until May 2023 and screened in duplicate by pairs of two reviewers. Inclusion criteria were qualitative data collection method, and patients' perspectives regarding healthcare focusing on work when experiencing work-related problems due to chronic medical conditions. Data extraction and synthesis was executed by means of an inductive thematic analysis approach. The quality of the included studies was assessed using the CASP Qualitative Study checklist. Confidence in the review findings was assessed through the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach.

Results: Out of 23,677 records, 97 qualitative studies were included. Needs regarding four main themes were identified: (1) Substantive guidance, which comprises the specific content of work-focused healthcare; (2) Clear and continuous process, which comprises clarification and optimization of the work-focused healthcare process; (3) Supportive attitude and behavior, which comprises a positive and supportive attitude and behavior from professionals towards the patients; and (4) Tailored approach, which comprises the delivery of tailored care to the individuals' needs. 17 subthemes were identified.

Conclusion: The broader insight in patients' needs in work-focused healthcare can help (occupational) healthcare professionals adopt a more patient-centred approach in practice.

Purpose: The decision whether to disclose a disability at work is complex. Drawing on communication theories, we examined disclosure decision-making and how workers with disabling health conditions prioritized information that could simultaneously encourage and discourage disclosure.

Methods: An online, cross-sectional survey asked workers with physical and mental health/cognitive conditions creating job limitations (i.e., disability) at work about the health impacts on their employment, their disclosure goals, preferences, support availability, workplace culture, work context, and demographic information. Descriptive, multivariate, and latent profile analyses were used.

Results: Participants were 591 workers (51% men, 48% women, 1% non-binary) with physical (41%), mental health/cognitive (24%), or both groups of conditions (35%). Forty-two percent of participants had not disclosed health information or needs to their supervisor. Six profiles of decision patterns were identified: (1) little health impact, supports available; (2) some health impacts, positive support appraisals; (3) some health impacts, uncertain what to do; (4) some health impacts, considerable personal concerns; (5) little health impact, few concerns, few supports available; and (6) considerable health impacts but perceives many risks to sharing. Disclosure decisions often prioritized personal goals, preferences, and workplace culture over health impacts and support availability. Profiles were differentiated by health condition type and work context.

Conclusion: Understanding how workers prioritize information when considering disclosing a disability at work has implications for organizational support practices and clinical efforts to support workers. It underscores that worker decisions go beyond health impacts and highlights the need for support resources to help workers address decision uncertainty and stress.

Purpose: Young workers face higher risks of workplace accidents, mental health issues, and physical strain. This scoping review aims to identify and summarize available research literature on barriers and facilitators to implementing workplace interventions to support young workers' safety, work environment and health.

Methods: We conducted a comprehensive search in bibliographic databases including PubMed, Web of Science and PsycInfo for articles published from 2007-2022. The PICO strategy guided the assessment of relevant studies and the bibliographical search for qualitative and mixed-method studies on interventions where (1) participants were young workers (mean age 15-29 years), (2) interventions were initiated and/or carried out at the workplace, and (3) barriers or facilitators to the implementation of interventions to support young workers' safety, work environment and health were described. We employed an iterative process to identify general thematic categories in the data.

Results: In total, 11 relevant studies were identified. Seven primary themes related to facilitators and barriers emerged from our analysis. Facilitators: fit the organizational context, organizational support, balance between efforts and gains, employee motivation, and employee involvement; Barriers: high workload and time pressure, shift work and irregular working hours.

Conclusion: There is a lack of intervention studies on young workers focusing on factors for implementation. The studies we find, reveal several factors to be aware of when designing and implementing interventions to support young workers' safety, work environment and health. The results emphasize a need for studies evaluating factors of importance for the successful implementation of workplace-based interventions among young workers.

Review registration: PROSPERO CRD42022324299 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324299 ).

Background: In response to rising unemployment rates among people with multiple sclerosis (PwMS) and poor working conditions in Latin America (LATAM), MS experts established the Quality-of-Life working group. This study aims to: (i) describe occupational outcomes and employment status among PwMS in LATAM; (ii) investigate the relationship between different levels of disability and ES; and (iii) Quantify accommodation use and explore potential clinical, cognitive, and sociodemographic predictors of job accommodations in LATAM.

Methods: A total of 86 PwMS were recruited from Argentina, Chile, Colombia, Mexico, and Paraguay, of whom 79 (91%) had a relapsing-remitting phenotype and 61 (70.9%) were women. The assessment protocol included the Brief Visual Memory Scale (BVMS), the Brief International Cognitive Assessment for MS (BICAMS), the MS Neuropsychology Screening Questionnaire, the Beck Depression Inventory II (BDI-II), the Fatigue Severity Scale (FSS), and a socioeconomic status (SES) survey.

Results: (i) Based on employment status characteristics, 47 PwMS (54.6%) were classified into the work-stable group, 18 PwMS (20.9%) into the work-challenged group, and 21 PwMS (24.4%) into the work-loss group, additionally clinical and sociodemographic characteristics are described. (ii) Hierarchical cluster analysis ranked PwMS into three groups based on cognitive and physical disability levels, showing that a lower level of disability was linked to a higher likelihood of maintaining stable employment. (iii) Job accommodations were predicted by greater self-awareness of cognitive impairment, higher socioeconomic status, higher education, and higher physical disability, all contributing to increased use of workplace accommodations.

Conclusion: Physical and neuropsychological disability increase the likelihood of being classified in the work-loss group, while factors such as self-awareness of cognitive impairment, socioeconomic status, level of disability, and education are associated with greater utilization of job accommodations. The work-loss rate among PwMS in LATAM was nearly three times higher than the general unemployment rate, underscoring the significant impact of MS on employment.