Journal of Occupational Rehabilitation最新文献

Purpose: To study associations of baseline predictors with work difficulties and number of working hours after one year in recently diagnosed people with multiple sclerosis (PwMS). Furthermore, to analyze whether these predictors are generic, i.e., apply to healthy people as well, or are disease specific.

Methods: TEMPRANO and MS@Work data were combined resulting in a dataset of 135 recently diagnosed PwMS (≤ 1 year) and 172 healthy people. We analyzed the associations of baseline predictors that fit within the international classification of functioning and health (ICF) framework using a mixed-effect negative-binomial model with log link for work difficulties and number of working hours after one year, and fitted each model using a fully Bayesian approach.

Results: Slower information processing speed was a disease-specific predictor for more work difficulties after one year (posterior mean ratio (PMR) = 0.82, 95% confidence interval (CI) = [0.69, 0.97]). Higher conscientiousness was a generic predictor for more working hours after one year (PMR = 1.02, 95%CI = [1.01, 1.03] for PwMS and PMR = 1.01, 95% CI = [1.00, 1.02] for healthy people). Being male (PMR = 0.75, 95% CI = [0.58, 0.96]), being younger (PMR = 0.99, 95% CI = [0.98, 1.00]), higher information processing speed (PMR = 1.08, 95% CI = [1.04, 1.13]), better learning and memory (PMR = 1.09, 95% CI = [1.03, 1.15]), and mentally burdensome job tasks (PMR = 1.36, 95% CI = [1.22, 1.52]) were disease-specific predictors for more working hours after one year.

Conclusion: For recently diagnosed PwMS, disease-specific predictors that fit within the ICF framework associate with perceived work difficulties and working hours after one year.

Purpose: To identify, summarize, and synthesize barriers and facilitators associated with interprofessional education (IPE) for work-focused healthcare professionals such as occupational physicians, social insurance physicians, and labor experts, to inform and stimulate interprofessional collaborative practice within the field of work-focused healthcare.

Methods: An integrative review was conducted to identify studies that report on IPE for work-focused healthcare professionals. Eight databases (APA PsycInfo, CINAHL, Cochrane, Embase, ERIC, Google Scholar, PubMed, Web of Science) were searched until March 2024. Reference lists of included articles were screened. Inclusion criteria were a description of an IPE activity of which at least one group of participants were work-focused healthcare professionals (in training). Barriers and facilitators were structured using the framework of Measurement Instruments for Determinants of Innovation (MIDI).

Results: From 6123 studies, seven were included. Barriers and facilitators were identified for each level of the MIDI framework. For example, at the level of characteristics of the IPE activity, involvement of skilled educators and reflection opportunities facilitated IPE. At the level of characteristics of IPE participants, role misunderstanding and lack of interaction hindered IPE. At the level of the organizational context, connection to work practice facilitated IPE. At the level of socio-political context, lack of support from external organizations hindered IPE.

Conclusion: Insights from this review can inform future IPE development. It is recommended that IPE is integrated in a learning continuum, is connected to daily practice, and includes reflection possibilities and training for interprofessional competencies.

Purpose: Inclusivity policies can positively impact labour shortages. The ideal approach to work ability services has shifted from being system centred to being individually tailored and human centred. Service systems are complex in many countries and case managers, referred to here as coordinators, play a key role in achieving the human-centred goal of increasing labour force participation. However, the literature on the practices of these coordinators and their distinct roles in supporting work ability and (re)employment and the contexts in which they do so is limited. This study aimed to clarify what these coordinators do and to explore the extent to which coordinating work meets the ideal of individualised support in different operating contexts.

Methods: The design was a mixed-method study, which utilised two data sources to answer the same complex questions. It consisted of surveys, and in-depth interviews that were based on its results. A total of 241 professionals from various services responded to these surveys, and 15 volunteers were interviewed. The questionnaire data were analysed using descriptive statistical methods, whereas the interviews were examined using thematic analysis. After this, the data were integrated according to a multi-level context framework.

Results: Initially, the coordinators from different sectors shared similar human-oriented values and ways of working. However, crossing administrative and organisational boundaries proved difficult, even though this was essential for the continuity of the client's process. As a result, ideal case management was not fully achieved.

Conclusion: The findings highlight a necessity for joint policies and practices, and organisational engagement to long-term collaboration.

Purpose: The study objectives were to (1) identify prevalent unhelpful worker-held pain and disability representations and (2) explore clinicians' intervention challenges with these representations.

Methods: An explanatory sequential mixed methods design was used (quan → QUAL). Secondary analysis of a database was performed first. The database included the scores obtained by 297 sick-listed workers with musculoskeletal disorders on the Revised Illness Perception Questionnaire for Work Disability. Descriptive statistics identified the most prevalent unhelpful worker-held representations. Quantitative results were used to develop an interview guide. Semi-structured interviews explored the physiotherapy professionals' (n = 8) and occupational therapists' (n = 6) intervention challenges with workers' pain and disability representations.

Results: The secondary data analysis showed that perceptions of severe consequences, unpredictable symptoms, and negative emotions were the most prevalent unhelpful worker-held representations. The interviews identified clinicians' key intervention challenges as two specific pain-and-disability representation patterns. The first depicted workers' perceptions of unpredictable and uncontrollable pain, perceptions that generate negative emotions. The clinicians associated this pattern with workers' sense of helplessness. The second pattern involved workers' firm beliefs in a biomedical cause, leading to their perceptions of low levels of treatment and personal pain control. According to clinicians, this pattern led to workers' resistance to active rehabilitation. The clinicians regarded both patterns as hindering worker engagement in rehabilitation treatment.

Conclusion: The clinicians' key intervention challenges were two pain-and-disability representation patterns, which included or not, prevalent unhelpful worker-held representations. The results underscore the need to develop a transdisciplinary intervention for work rehabilitation clinicians that takes pain and disability representations into account.

Purpose: Workplace health interventions with exercise have positive effects on musculoskeletal pain and well-being at work, however, effectiveness is questioned due to low adherence. In hospitals participation is challenged by shiftwork and unpredictable workload. Our aim was to investigate the feasibility of exercise during working hours in an acute hospital, herein to estimate the health impact to guide management decisions on implementation.

Methods: A clinical trial in a public hospital, offering staff supervised group-based individualized exercise with combined aerobic and strength training during working hours twice weekly for 20 weeks. Delivery, acceptance, and adherence were investigated. Subjective outcomes were social capital, well-being, quality of life, and musculoskeletal pain were assessed. Objective outcomes were blood pressure, body composition, and cardiorespiratory fitness.

Results: Twenty-three percent of the employees (n = 617) accepted participation (92% female, median age was 50 years, 38% nurses). Adherence was 29% with no difference between employees with clinical versus non-clinical functions. Non-clinicians participated during working hours, while clinicians participated outside of working hours in 50% (IQR 5-87) of the sessions. Positive changes were seen in systolic and diastolic blood pressure (decreased 2.0 [0.9; 2.2] and 0.9 [0.1; 1.7] mmHG, respectively), aerobic capacity 2.3 ml/O2/min/kg [1.7; 2.9], and in waist-hip ratio, social capital, well-being, quality of life, and musculoskeletal pain.

Conclusion: Exercise during working hours in an acute hospital staff was feasible, but strategies to increase acceptance and adherence are necessary for a successful implementation. Despite low adherence, the intervention was associated with improvements of physical and mental health.

Registration: The study protocol has been uploaded on www.

Clinicaltrials: gov (NCT04988724).

Purpose: To consolidate the emerging evidence on the effectiveness of resistance training (RT) in reducing the health risks among sedentary office workers.

Methods: Four electronic databases were searched for evidence from its inception till september 20, 2024. Studies were included if they examined any form of RT program targeting musculoskeletal, metabolic, or psychological health outcomes in office workers aged 18 years or older using PICOS criteria (Population - office workers, Intervention - RT program, Comparison - placebo or sham control and Outcomes - musculoskeletal, cardiometabolic and psychological health variables). Two reviewers independently screened the studies for risk of bias and assessed the certainty of the evidence.

Results: Out of 60 identified studies, 17 studies were eligible for narrative synthesis, and 16 were included in the meta-analysis. Modest reductions in neck (SMD = -1.76, I² = 88%, p < 0.00001) and shoulder discomfort (SMD = -13.29, I² = 91%, p < 0.00001), while marginal improvement in shoulder (SMD = 4.13, I² = 99%, p = 0.03) and neck extensor muscle strength (SMD = 9.07, I² = 9%, p < 0.00001). The cardiometabolic and mental health risk markers remain unaltered. High uncertainty of evidence was observed due to high heterogeneity, risk of bias, inconsistency and publication bias.

Conclusion: Limited evidence demonstrate supervised RT programs of any dose has a potential to improve muscular strength and discomfort while potential cardiometabolic and mental health risk outcomes remain unaltered. However, more high-quality research trials are needed to understand the effects of RT on health benefits.

Objectives: We sought to identify whether the inclusion of pregabalin on the list of medicines subsidised by the Australian government in 2013 resulted in changes to the dispensing of pregabalin to Australians with workers' compensation claims for low back pain.

Methods: Using a sample of workers' compensation claims and payments data (2010-2018), we measured the prevalence of pregabalin dispensing and time to first pregabalin dispensing in workers whose claim began before, during or after pregabalin was listed on the Pharmaceutical Benefits Scheme (PBS) with binary logistic and Cox proportional hazards models. We used interrupted time-series analyses to measure changes in the monthly number, percentage of pain medicines, percentage of gabapentinoid dispensings, and median cost per dispensing of pregabalin.

Results: Of the 17,689 workers included in the study, 13.7% (n = 2431) were dispensed pregabalin during the study period. Workers in the groups whose claim occurred before or during when pregabalin was listed on the PBS were at significantly lower odds of being dispensed pregabalin than the group whose claim began after PBS listing (OR 0.20, 99% CI 0.15, 0.25 and OR 0.40, 99% CI 0.33, 0.48, respectively). There were significant step increases in the number of pregabalin dispensings (26.3%, 99% CI 6.2%, 50.3%), percentage of pain medicines that were pregabalin (29.3%, 99% CI 1.5%, 64.9%), and percentage of gabapentinoid dispensings that were pregabalin (13.9%, 99% CI 7.5%, 20.6%). There was a significant step decrease in the median cost per pregabalin dispensing (- 61.8%, 99% CI - 66.8%, - 56.1%).

Conclusion: Listing pregabalin on the PBS saw significant increases in the prevalence, number and percentage of pain medicines, and significant decreases in time to first pregabalin dispensing and cost.

Purpose: This systematic literature review aims to list the validated tools measuring work-related psychosocial factors (WRPFs) influence health care workers' (HCWs) sickness absence (SA), and to evaluate their psychometric and practical properties.

Methods: Using the PsycINFO, Medline, and Web of Science databases, the search targeted prospective studies on WRPFs and SA in HCWs published between 2012 and 2023. The validated, self-report tools that measured WRPFs and that yielded at least one significant predictor of SA in HCWs were identified. An evaluation of the psychometric and practical properties was performed.

Results: Based on inclusion criteria, three prospective studies on HCWs were included, and twelve tools were listed. Psychometric and practical properties were "excellent" for six tools, "good" for four, and "questionable" for two.

Conclusions: Researchers and occupational health practitioners can use tools with "good" to "excellent" overall quality to measure traditional WRPFs that predict SA in HCWs. There is a need to develop and validate tools that measure WRPFs representing the specific characteristics of the health care working environment. Other WRPFs relevant to the work context of HCWs can be measured by extant tools that could be used in research and program development and evaluation.

Purpose: A main goal during the return to work (RTW) process after a long-term sickness absence due to common mental disorders (CMDs), is to restore and maintain employees' work ability to enable their sustained work participation. This study jointly examined employees' work ability ratings and experiences during their RTW process with CMDs.

Methods: In a mixed methods follow-up study of N = 286 participants, work ability was quantitatively assessed with the Work Ability Score (WAS, range 0-10) at baseline (week before clinical discharge) and after 6, 12, 18, and 30 months. In a sub-sample, the qualitative work ability experiences of N = 32 participants were analysed at 6 and 12 months, and were jointly evaluated with the quantitative data.

Results: The mean WAS increased during the first 18 months of follow-up. Three groups of qualitative work ability experiences emerged: Employees with (1) poor work ability (WAS 0-3), who did not RTW yet and described great difficulties in coping with everyday life, (2) moderate work ability (WAS 4-6), who mainly did RTW, but still showed a certain level of fragility, and (3) good to very good work ability (WAS 7-10), who mainly returned to work and reported many individual and work accommodations to maintain their work ability.

Conclusion: The present study provides new insights into different aspects of work ability experiences, especially during the later RTW phases, where restoring and maintaining work ability is essential for a sustained work participation. This knowledge may help RTW stakeholders to better tailor support during the RTW process.

Purpose: The aim was to analyse the relationships between work environment characteristics and periods of sick leave (> 14 days) in individuals diagnosed with common mental disorders (CMDs) across 1993-2014. Additionally, the study describes changes in the work environment and sick leave trends over these two periods.

Methods: From the Swedish Work Environment Surveys (SWES) 1993-2013, participants with a diagnosis of a CMD up to five years before the interview were drawn (n = 3795). Risk ratios (RRs) of the annual average number of sick leave days one year after the interview in SWES (1993-2014) were calculated for various work environment characteristics, along with 95% confidence intervals (CIs).

Results: Having flexible working hours (RR 0.65: 0.46-0.91) and having an active job (RR 0.60: 0.41-0.88), that is, high job demands and high job control, were associated with a significantly decreased risk for a spell of sick leave > 14 days after adjusting for interview year, age, sex, and educational level. There was a tendency that also some aspects of job control, i.e. influence over working hours (RR 0.79: 0.62-1.01) and influence over work pace (0.80: 0.62-1.03), were associated with a lower risk of having  > 14 days of sick leave. There was a more substantial effect on these work environment factors in 2009-2013 than 1993-2007.

Conclusion: Enabling flexible working hours and influencing work pace and working hours can decrease the risk of sick leave among employees diagnosed with a CMD.