Journal of Occupational Rehabilitation最新文献

Purpose: Through electronic health records (EHRs), musculoskeletal (MSK) therapists such as chiropractors and physical therapists, as well as occupational medicine physicians could collect data on many variables that can be traditionally challenging to collect in managing work-related musculoskeletal disorders (WMSDs). The review's objectives were to explore the extent of research using EHRs in predicting outcomes of WMSDs by MSK therapists.

Method: A systematic search was conducted in Medline, PubMed, CINAHL, and Embase. Grey literature was searched. 2156 unique papers were retrieved, of which 38 were included. Three themes were explored, the use of EHRs to predict outcomes to WMSDs, data sources for predicting outcomes to WMSDs, and adoption of standardised information for managing WMSDs.

Results: Predicting outcomes of all MSK disorders using EHRs has been researched in 6 studies, with only 3 focusing on MSK therapists and 4 addressing WMSDs. Similar to all secondary data source research, the challenges include data quality, missing data and unstructured data. There is not yet a standardised or minimum set of data that has been defined for MSK therapists to collect when managing WMSD. Further work based on existing frameworks is required to reduce the documentation burden and increase usability.

Conclusion: The review outlines the limited research on using EHRs to predict outcomes of WMSDs. It highlights the need for EHR design to address data quality issues and develop a standardised data set in occupational healthcare that includes known factors that potentially predict outcomes to help regulators, research efforts, and practitioners make better informed clinical decisions.

Purpose: The objectives of this paper were to summarize successful strategies in occupational health and safety (OHS) management in small and medium-sized enterprises (SMEs) and to explore their potential applicability for disability management (DM) and return-to-work (RTW) after work-related injuries.

Methods: A scoping review was conducted, using a consensus-based iterative approach, and a consultation with stakeholders. Twelve databases were searched in collaboration with a specialized librarian, using keywords and combinations of terms. The reviewers identified pertinent articles, selected those which corresponded to the inclusion criteria, extracted data, and analyzed information using qualitative content analyses. A synthesis was presented to the stakeholders, and their comments on overall applicability of these strategies in the Quebec context of DM and RTW were detailed.

Results: A total of 638 references were retrieved from all sources, resulting in 37 scientific articles being analyzed. Four main strategies for improving OHS management in SMEs were identified: dissemination and exchange of information; transmission and acquisition of knowledge, skills, and abilities; using a participatory and collaborative approach; and considering the organizational context. Even if DM and sustainable RTW were sometimes mentioned by authors as important for OHS management in SMEs, specific strategies and implementation elements were not actually described by authors. However, different resources, structures, and activities, associated with one or more of the OHS management strategies described, through their different interactions between the various stakeholders, seem having the potential to act also in sustainable RTW.

Conclusion: This review has provided an overview of strategies deployed to improve OSH in SME. The results invite stakeholders to a deep reflection on the potential application of such strategies to encompass sustainable RTW in SMEs.

Purpose: To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers.

Methods: We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal-Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders.

Results: A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70-0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84-0.99). Associations were no longer significant when confounders were controlled for.

Conclusion: RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format.

Purpose: To describe the volume, timing and provider of mental health services provided to workers with accepted low back pain (LBP) claims, and to identify determinants of service volume and time to first mental health service.

Methods: Using claim and service-level workers' compensation data from four Australian states (Queensland, South Australia, Western Australia, Victoria) for LBP claims with at least one mental health service lodged between 1 July 2011 and 30 June 2015. Mental health services occurring 30 days prior to 730 days following claim acceptance were examined. Outcomes were number of mental health services and time (weeks) from claim acceptance to first service, calculated overall, by provider and interaction type, and by independent variables (age group, sex, time loss duration, financial year of lodgement, jurisdiction, socioeconomic status, remoteness). Negative binomial and Cox regression models examined differences between service volume and time to first service by independent variables, respectively.

Results: Of workers with LBP claims who accessed mental health services, psychologist services were most common (used by 91.2% of workers) and 16% of workers saw multiple provider types. Number of services increased with time loss duration, as did time to first service. Victorian workers had the most services, yet accessed them latest.

Conclusions: Psychologist services were most common, longer duration claims used more mental health services but accessed them later, and there were a number of jurisdictional differences. Results suggest opportunities for workers' compensation authorities to provide, to those who may benefit, greater and earlier access to mental health care.

Purpose: Due to the Belgian health insurance system's controlling nature, work-disabled claimants can feel forced to return to work (RTW), increasing their risk of relapse. RTW out of interest or importance is considered more sustainable. Such autonomous motivation for RTW can be promoted through 'motivational counselling', an integration of self-determination theory and motivational interviewing. To adopt this, health insurance practitioners need training, which can be designed through intervention mapping as an evidence-based planning tool. This paper reports on the development of a motivational counselling training for health insurance practitioners.

Methods: Intervention mapping's six steps guided the formulation of programme goals and learning outcomes, matching the context. We then identified change methods which were translated into practical components. Together with the health insurances' input, this resulted in a concrete training programme with an implementation and evaluation plan.

Results: The training was designed to increase practitioners' knowledge, skills, and beliefs relevant for learning motivational counselling, which also requires solution-focused strategies. Methods like guided practice were translated into built-in exercises, feedback, and information, which were implemented through an online training format of five sessions including one follow-up.

Conclusion: Reporting about training development increases understanding of its effectiveness and implementation, which will be evaluated via pre- and post-training data collection amongst practitioners. Future trainings can benefit from this by accounting for health insurances' organizational barriers or building on the training's evidence-based backbone whilst only requiring specific adaptations for other stakeholders and contexts. Further research should evaluate motivational counselling's impact on claimants' RTW trajectories.

Purpose: Inclusive recruitment and employment of autistic adults has garnered recent attention in research and policy. To address a need to better understand the experiences of autistic adults in relation to paid employment, we asked the literature, what are the experiences of autistic individuals (from their perspectives) in competitive employment?

Methods: A scoping review was conducted to summarize and consolidate the findings across research to date. A systematic search and screen of the literature resulted in 32 relevant studies.

Findings: Key study characteristics, participant demographics, and thematic findings are shared, along with considerations and recommendations for future research and practice. Six key themes were described by autistic participants across the 32 studies: (1) accessibility of employment, (2) workplace relationships and communication, (3) role alignment, (4) sensory needs and/or mental health, (5) colleagues' knowledge and beliefs about autism, and (6) family and community context.

Conclusion: It is anticipated that the results of this review will be beneficial for stakeholders engaging in discussions and decision-making across research and employment contexts.

Purpose: To evaluate the acceptability and feasibility of a consumer co-designed telehealth intervention which aimed to reduce claimant distress by providing pain management strategies, informational and social support to people who had made a compensation claim following road traffic musculoskeletal injury.

Methods: Eleven claimant participants who were at risk of a poor outcome completed the intervention in a one-on-one setting with the same clinician delivering the program across all sessions.They were interviewed about their experience (acceptability and feasibility including the use of telehealth). Clinicians who delivered the intervention also completed an anonymous feedback survey exploring their experiences delivering the intervention. Interviews were transcribed verbatim and thematic analysis was conducted.

Results: There were four themes which broadly related to the acceptability and feasibility of the intervention as well as the perceived benefits: (1) knowledge is power, (2) healing with social connection, (3) further along than I would have been, and (4) telehealth was acceptable and feasible.

Conclusion: The delivery of a co-designed telehealth-delivered stress mitigation intervention to support people with a road traffic musculoskeletal injury was feasible to deliver and acceptable to people who were at risk of a poor outcome. Further research to evaluate the efficacy of the intervention on outcomes such as pain, self-efficacy, and claims costs are needed.

Purpose: Hematopoietic cell transplantation (HCT) is a common treatment for people diagnosed with hematological cancers. However, it can cause side effects that may affect work participation. This scoping review aims to provide an overview of the factors that influence the work participation of hematological cancer survivors who have undergone HCT.

Methods: We conducted a scoping review following the Joanna Briggs Institute guidelines and developed our search strategy in collaboration with a scientific librarian and searched nine databases (CINAHL, MEDLINE, EMBASE, Cochrane, PubMed, PsycINFO, Web of Science, Scopus, ProQuest Dissertations, & Theses Global) for primary studies in French or English until February 2024. Two reviewers extracted the data and analyzed it thematically. We synthesized and presented the findings using a narrative description approach.

Results: We identified 940 publications, of which 36 met the eligibility criteria. Our findings underscore the significance of considering individuals over 50, those undergoing allogeneic HCT, women, and those with lower incomes. We noted disparities in evaluating or describing work participation.

Conclusion: It is crucial for researchers and healthcare professionals in hematological care to be aware of the intersecting factors that influence work participation. There are still significant gaps in how workplace dynamics, legislation, and healthcare systems affect the return to work process.

Background: Complete mental health encompasses both mental illness (MI) symptoms and positive mental health (PMH). Distinct profiles of MI and PMH have not been explored among injured workers. This study describes latent mental health profiles among workers with a disabling physical work injury/illness and identifies differences in sociodemographic and return-to-work factors, health correlates, and disability claim duration and cost between profiles.

Methods: 1132 Ontario workers with a physical work-related injury/illness who received lost-time claim benefits were surveyed 18 months post-injury. MI was defined by the self-reported presence of a mood and/or anxiety disorder diagnosed by a healthcare professional pre- or post-injury. The Mental Health Continuum Short Form measured aspects of PMH. Claim information was obtained via administrative records. Latent profile analysis identified the unique number of MI and PMH profiles. Chi-Square and ANOVA tests compared sociodemographic, return-to-work, health, and claim outcomes between classes.

Results: Four latent MI and three latent PMH classes were uncovered. Eighteen percent of participants exhibited high MI symptoms diagnosed pre- and post-injury and 14% exhibited languishing PMH. Classes with higher MI burden and languishing PMH were more likely to report financial concerns during their claim, pain interference, other health conditions, and opioid use. Claim duration and wage-replacement benefits were ~ 20 days longer and ~ $2000 greater, respectively, among the highest MI and lowest PMH classes.

Conclusions: Workers' compensation claimants exhibit both flourishing and languishing mental health profiles. The demographic, health, and return-to-work characteristics of latent classes may help identify claimants who may benefit from additional psychological support when returning to work.

Purpose: By considering work-related aspects during early intervention and treatment of employees with (subclinical) symptoms of common mental disorders, psychotherapeutic consultation at work (PT-W) aims to increase work-specific self-efficacy (SE) to finally reduce sickness absence and contribute to successful return to work. This study, thus, aims to investigate interrelations between working conditions and work-specific SE among employees before receiving PT-W.

Methods: The study uses baseline data of a randomized controlled trial testing the efficacy of PT-W in Germany (n = 535). Working conditions were assessed by six scales of the validated Copenhagen Psychosocial Questionnaire (COPSOQ). SE was assessed by the validated general short occupational self-efficacy (OSE) scale and return-to-work self-efficacy (RTW-SE) scale, two specific forms of self-efficacy. Multiple linear regression models were calculated using working conditions as independent and self-efficacy as dependent variables. Interactions between working conditions and age, gender and current extent of work were added to those models.

Results: Results suggest that quantitative job demands are negatively and development opportunities are positively related to OSE and RTW-SE. Age did not moderate those relationships. The association between development opportunities and OSE was stronger among employees indicating working less number of hours than specified in their contract compared to employees indicating working their full contract hours. Furthermore, interactions with gender were found with social support being only (positively) associated with OSE among male and decision authority being only (positively) associated with OSE among female employees.

Conclusions: The associations between working conditions and work-specific SE support the usefulness of addressing potential reciprocal relationships between those two variables during PT-W to improve mental health of employees.

Trial registration number: Registered at the German Clinical Trial Register (DRKS) at 01.03.2021-DRKS00023049.