Journal of Occupational Rehabilitation最新文献

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.

Purpose: The aim of this systematic review was to summarize the qualitative evidence on factors of effective counseling aiming at work participation for people with chronic diseases and/or disabilities.

Methods: We conducted a systematic literature search in MEDLINE (PubMed), CINAHL, Web of Science, PsycINFO, and PubPsych in March 2023. Our inclusion criteria stipulated that counseling should be specifically designed for individuals experiencing constraints in work participation and published in German or English between 2013 and 2023. To assess the quality of the included studies, we used the checklist of the Critical Appraisal Skills Programme. We synthesized our findings according to the meta-ethnographic methodology by Noblit and Hare.

Results: Of the 2901 papers found in the systematic search, we included 16 qualitative studies in our meta-synthesis. Studies were conducted in Australia, the USA, Canada, Nordic countries, and Germany. Our "model of the effectiveness of counseling for work participation" consists of four levels. At the extended organizational level, potential factors include the provision of sufficient time and work resources for counselors or contact persons. At the team and stakeholder level, structural collaboration, for example, is crucial. In the counseling dyad, counselors can employ shared decision-making and at the individual level, personal character traits and the client's motivation are exemplary factors.

Conclusion: This study provides a comprehensive overview of factors contributing to effective counseling in the context of work participation. The delineation across various levels underscores that effectiveness in counseling is a collective outcome, involving not only the advisor but also other stakeholders.

Purpose: The Work Rehabilitation Questionnaire (WORQ) assesses patient functioning, including psychological, physical, and cognitive limitations. This study evaluates the WORQ domains in individuals with persistent low back pain (LBP), focusing on reliability and construct validity.

Methods: Individuals aged 18-65 with LBP completed WORQ and the workability index single item. A subgroup undertook sit-to-stand and 6-min walking tests and re-evaluated WORQ after 14 days. Reliability was assessed through internal consistency (McDonald's omega and Cronbach's alpha), test-retest reliability, and smallest detectable change. Construct validity was analyzed via Spearman's rank correlation and known group validity, with physical functioning also examined against sit-to-stand and 6-min walk test results for sensitivity/specificity. Floor and ceiling effects were assessed through classical and scale width methods.

Results: Of 425 participants, 149 completed physical tests, and 102 re-assessed WORQ. McDonald's omega and Cronbach's alpha indicated high internal consistency (0.92-0.96) with strong test-retest reliability (intraclass-correlation coefficients: 0.74-0.82). The smallest detectable change ranged from 4.62 to 7.82. Predictions from 7 out of 8 hypotheses were confirmed. Notable differences in domain scores were observed based on disability level and sick leave status, with varied diagnostic performance in physical functioning items. Potential floor effects were noted using the scale width method.

Conclusions: The WORQ demonstrated good reliability and satisfactory validity in assessing work-related functioning in individuals with persistent LBP. These findings support its use as a comprehensive tool for evaluating psychological, physical, and cognitive limitations. However, varied diagnostic performance in physical functioning items and potential floor effects suggest cautious interpretation in diverse clinical settings.

Purpose: Employment provides people with physical disabilities (PWPD) financial independence, enhances their well-being, self-worth, and facilitates a sense of purpose. However, the unemployment rate for PWPD is significantly higher than for individuals without a disability. There is limited knowledge regarding what factors help people with disabilities retain employment beyond the standard 90-day job probationary period. Thus, we investigated person-, job-, and environment-related factors that contribute to long-term job retention for four years or more among PWPD.

Methods: We recruited a national sample of 1500 PWPD who had work experience after disability onset from panels assembled by a market research organization. We compared a subsample that maintained their longest held job for at least four years with those who had not using multivariate Poisson regression. Three models evaluated the association between job retention and (1) person-, (2) job-, and (3) environment-related factors.

Results: Likelihood of job retention was greater for respondents reporting fatigue or emotional problems (vs. pain), advancement opportunities, and receipt of job accommodations. Concerns about limited career advancement opportunities, perception of unimportance about disclosing a disability to coworkers, and difficult work commutes were associated with shorter job retention.

Conclusion: Several person-, job-, and environment-related factors play an important role in promoting job retention of people with physical disabilities. Employers, job coaches, and rehabilitation professionals should consider these factors when developing strategies to support the retention of PWPD. Future studies should examine the relationship between these factors and their associations with the employment outcomes of PWPD across work settings and industries.

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.