Journal of Occupational Rehabilitation最新文献

Purpose: Functional testing is important to inform return-to-work (RTW), but new paradigms are needed to increase access and availability of testing. Our purpose was to deploy a user centred design approach to collect, describe, and interpret end-user feedback (clinicians and patients) to inform functional requirements for a remotely administered hybrid functional test (RAHFT) protocol.

Methods: Twenty participants (10 clinicians and 10 patients) were interviewed about existing in-person functional testing and about perceptions of prospective remotely administered functional testing protocols. Interview data were synthesized, where findings informed a focus group with functional testing clinician experts to identify functional design requirements for a RAHFT protocol.

Results: Patients agreed that access to equipment and technology, safety, and personal connections were important requirements for a functional testing protocol. Expert clinicians emphasized that a RAHFT should provide valid information to inform treatment planning and RTW outcome decisions, inclusive of opportunities to capture subjective and performance-based information.

Conclusions: RAHFT protocols can play an important role towards early and safe RTW. RAHFT protocols will increase availability and improve access for workers that cannot easily attend a clinic for in-person testing. Findings from this study provide functional requirements that should be considered when designing RAHFT protocols.

Purpose: The purpose is to examine perceptions of pity directed toward people with disabilities to gain a deeper understanding of the effect of these perceptions on the employment success of people with disabilities and to provide direction to disability-related training and strategic planning in the workplace.

Methods: Two studies were developed to explore these relationships. The first measured the characteristics most frequently associated with people with disabilities in the workplace. Survey respondents rated the degree to which they believed the average person would assign these several characteristics to people with disabilities. The second measured the degree to which perceptions of pity, as directed toward people with disabilities, were correlated with the apparent complexity of those disabilities. Respondents determined the relative amount of money that passers-by would likely donate to panhandlers who used various mobility equipment (i.e., wheelchair, walker, cane).

Results: Results from these studies indicated that people with disabilities were more likely to be assigned a preponderance of negative characteristics, including those described as unfortunate, limited, and tragic. In addition, people with disabilities whose disabilities were perceived as more complex were seen as being more in need of financial assistance.

Conclusion: By providing an empirically driven starting point for organizational planners, including human resource professionals, managers, and recruiters, these two studies provide a basis upon which to develop strategies that account for these affect-based responses to disability.

Purpose: Major depressive disorder (MDD) is one of the leading causes of work-related disability, and accessing telehealth therapies can be a promising modality for workers with MDD. Barriers to accessing in-person mental healthcare, such as limited availability and accessibility in rural and remote communities, financial constraints, and stigma, have highlighted the need for alternative approaches like telehealth. This study investigated the efficacy of telehealth interventions including CBT for adults over 18 diagnosed with MDD.

Methods: This rapid review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure a transparent methodology. Out of the 2549 studies screened, 19 were incorporated into the rapid review, and of those, 10 were included in the subsequent meta-analyses. Articles were screened independently by two reviewers, with the disagreements reconciled through discussion. A reviewer extracted data from eligible articles. Descriptive statistics and narrative syntheses were used to describe outcomes. Two meta-analyses were conducted to investigate the efficacy of cognitive behavioral therapy (CBT) delivered by telehealth (tCBT). The first compared tCBT to in-person CBT (pCBT). The second meta-analysis compared tCBT to a control group that did not receive CBT or another telehealth-based treatment. Non-CBT interventions investigated within the non-CBT group included somatic rhythm therapy, problem-solving therapy, psychiatry, behavioral activation, and interpersonal psychotherapy.

Results: Overall, individuals with MDD who received tCBT showed significant improvement in depression symptoms. However, the efficacy of tCBT compared to non-telehealth control groups varied across studies. The first meta-analysis indicated the magnitudes of effect were similar for both interventions in reducing depression symptoms 0.023 (95% CI - 0.120 to 0.166); p = 1.00. In the second meta-analysis, the ratio of means comparing tCBT (0.51 ± 0.14 SD) to the control group (0.68 ± 0.12 SD) exhibited a statistically significant 25% reduction with regard to depression scores (one-sided p = 0.002), favouring tCBT to non-telehealth, non-CBT study groups.

Conclusions: Telehealth-based CBT demonstrated positive effects on depression symptoms; it was generally superior when compared to control groups not receiving CBT and was on par with pCBT. The growing mental health burden in the community underscores the need for accessible telehealth services like tCBT. Effective policy formulation and implementation in national health agendas are essential to meet the increasing demand for mental health support.

Purpose: The purpose of this study was to investigate predictors for return to work for people struggling with common mental disorders on sick leave or at risk of sick leave. The first aim of this study was to evaluate the psychometric properties of a set of statements exploring different conditions at the workplace and assumptions about working with health problems, by investigating the factor structure, reliability and construct validity of these statements. The second aim of this study was to investigate the predictive value of the identified factors.

Methods: A total of 797 patients from an outpatient mental health clinic were included in a naturalistic observational study. The study design was longitudinal. The participants filled out self-report questionnaires pre- and post-treatment.

Results: A principal component factor analysis with a varimax rotation identified two factors, Negative beliefs about working with health problems and Support at work, displaying high internal consistency, 0.83 and 0.84, respectively. Separately, both factors were significant predictors of full return to work after treatment. The final multivariable analysis including both factors left Negative beliefs about working with health problems as a significant predictor explaining unique variance.

Conclusions: Negative beliefs about working with health problems and Support at work are important predictors for work status after treatment and should therefore be addressed during treatment for common mental disorders to assist people return to work.

Objective: Major organizational changes may be associated with both positive and negative uncertainty in working life. This study described the prevalence of organizational changes (reorganizations or round of layoffs) within different job functions in Denmark and investigated whether quality of the implementation process (measured as "information", "involvement" and "consent") was associated with employees' expectations regarding retirement age.

Methods: A representative sample of older Danish employees ≥ 50 years (n = 12,269) replied to a questionnaire survey in 2020. In cross-sectional analyses, we compared employee's expected retirement age being either not exposed to organizational changes or exposed to implementation processes of high, moderate or low-quality, respectively. Analyses were further stratified for job function: office work, work with people and work in the field of production.

Results: More than half (56%) of the employees had experienced organizational changes within the past 2 years, and 23% of those effected reported that the changes had led to considerations of earlier retirement. Organizational changes were most prevalent within office work, and least prevalent within the job function working with people. The analyses showed significantly lower expected retirement age when the implementation process had been of moderate (mean reduction of 0.45 years) or low quality (mean reduction of 0.71 years) compared to high quality implemented changes.

Conclusions: Experiences of organizational change processes of moderate or poor quality were associated with expectations of earlier retirement, while well implemented changes were not. This study underscores the importance of good implementation when changes at the organizational level are needed.

Purpose: This study aimed to explore the meaning of work participation for people with spinal cord injury (SCI) in Bangladesh.

Methods: Narrative inquiry methodological framework was used to explore the meaning of work participation after SCI. Face-to-face interviews with twenty adults with SCI, who were either living in the community or in-patients at a rehabilitation center. The Worker Role Interview questionnaire was used as an interview guide. Participants were descriptively analyzed in two groups, rehabilitation participants and community participants. Their transcripts were analyzed using individual narrative analysis to understand the meaning of their experience at an individual level and then the findings from the individual narrative analyses were summarized using thematic analysis to identify themes that collectively represented the meaning of work after SCI in Bangladesh.

Result: Five themes were identified from the interviews: "work life before injury"; "current life in relation to work"; "framing future prospects of work participation"; "motives for working"; and "enablers of work participation."

Conclusion: The meaning of work is subjective and is influenced by the participants' pre-existing experiences and other factors related to their work life, such as work preferences, habits, and daily routines. Therefore, creating opportunities to better understand the meaning of work for each individual and incorporating these factors into rehabilitation are keys to sustainable rehabilitation outcomes.

Purposes: To measure the test-retest reliability and the clinical usefulness of the Work Limitation Questionnaire, and to compare the in-person with the telephone application.

Methods: Cross-sectional, exploratory study. The Work Limitation Questionnaire was answered three times: twice in person, to measure test-retest reliability and clinical usefulness, and once, by telephone, to measure the validity of the telephone application.

Results: Fifty-six individuals (32 men) with mild to moderate disabilities after stroke were included. Test-retest reliability was very high (ICC 0.96; 95% CI 0.94 to 0.98; p < 0.01), the clinical usefulness was high (9 out of 12 points), and the correlation between in-person and telephone applications was high (ρ = 0.7; 95% CI 0.5 to 0.9; p < 0.01). The average productivity loss was 4% (SD 5, min-max 0 to 15%).

Conclusions: The Work Limitation Questionnaire showed adequate test-retest reliability and clinical usefulness in individuals with stroke. The telephone application produced comparable results to in-person applications. The participants reported low productivity loss, which may be related to the mild impairments of the included sample.

Purpose: The aim of the study is to examine the role of unmet needs for workplace accommodations (WPA) in the labor force status of persons with disabilities (PWD) aged 25-64 years.

Methods: The study used data from the 2017 Canadian Survey on Disability and multinomial logistic regressions to estimate the predicted probabilities of employment, unemployment, detachment from the labor force, and retirement. Product terms were used to examine if the association between unmet needs for WPA and these employment outcomes depended on severity of disability and age group.

Results: The findings show that the probability of employment was far lower for PWD with unmet needs for WPA than it was for their counterparts without unmet needs, after controlling for disability-related and sociodemographic characteristics. While having more severe disabilities associated with a lower employment rate, this occurred in the context of unmet needs for WPA, as there was no difference between persons with milder and more severe disabilities without unmet needs. Unmet needs for WPA had age-specific consequences and were associated with a higher probability of unemployment and detachment from the labor force among PWDs aged 25-34 years and a higher probability of retirement among PWD aged 55-64 years.

Conclusion: Unmet needs for WPA are a barrier to the employment chances of many PWD and eliminating these unmet needs could increase their inclusion in the labor force.

Purpose: This systematic review and meta-analysis aimed to synthesize the evidence and examine the effect of telerehabilitation interventions compared to face-to-face rehabilitation interventions on physical functioning, mental health, and pain reduction among employed individuals, 18 years old and older.

Methods: Following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search syntax was created and inputted into Ovid Medline, APA PsycINFO, Ovid Embase, CINAHL, and Scopus. Critical appraisal of the included studies was conducted by two researchers to assess the risk of bias. A meta-analysis was completed for the randomized controlled trials and GRADE was used to determine the certainty of the evidence.

Results: A total of 16 out of 4319 articles were included in this review. This systematic review and meta-analysis found no significant differences between telerehabilitation interventions for physical functioning, mental health, and pain reduction outcomes compared to traditional rehabilitation interventions.

Conclusion: The study findings indicate that telerehabilitation is less effective than in-person care for occupational therapy and physical therapy services. Future research may look at addressing the limitations of the current study to produce more conclusive results, such as exploring the length of the intervention, knowledge and confidence of intervention application, and follow-ups.

Systematic review registration: This systematic review has been registered with PROSPERO under registration number CRD42022297849 on April 8th, 2022.

Purpose

Vocational retraining centers in Germany provide retraining for adults who are unable to continue their previous occupation due to health conditions. In addition to education and training, the centers provide support services, including the psychological service that assists rehabilitees in maintaining or regaining their mental stability. This study investigated which socio-demographic, health-related, and rehabilitation-related factors are associated with return to work (RTW) and examined the use of the psychological service and its association with RTW.

Methods

Data consisted of administrative data and service records routinely collected at one vocational retraining center. A total of 1187 individuals who began vocational retraining between 2016 and 2018 were analyzed. Logistic models predicting RTW and including interaction terms were used.

Results

Several factors were associated with RTW (Nagelkerke's Pseudo-R² = 0.173), including socio-demographic factors, e.g., age (OR 0.96, 95% CI [0.93, 0.98]), health-related factors, e.g., number of diagnoses (OR 0.85, 95% CI [0.77, 0.93]), and rehabilitation-related factors, e.g., discontinuation of training (OR 0.24, 95% CI [0.15, 0.38]). The proportion of women, rehabilitees attending boarding school, and rehabilitees pursuing a career in the commercial and administrative sector was higher among frequent users of the psychological service compared to non/occasional users. The proportion of rehabilitees diagnosed with ICD F was also higher among frequent users, as was the number of diagnoses. Moreover, an interaction was found between absence and psychological service utilization on RTW.

Conclusion

The analysis of routinely collected data in a vocational retraining center is suitable to investigate individual-level factors associated with RTW. The interaction suggests a compensatory effect, i.e., that frequent use of the psychological service mitigates the negative effect of absence on RTW.