Journal of Occupational Rehabilitation最新文献

Purpose: This scoping review study aimed to provide a comprehensive overview of the literature on collaboration between sickness benefit offices and general practice in return to work (RTW) processes, to map existing research, and to identify facilitators and barriers to successful collaboration.

Methods: This review adhered to established scoping review methodologies. A systematic search of peer-reviewed literature was conducted across six databases. Two researchers independently performed screening and data extraction. Facilitators and barriers were thematically analysed, and tentative findings were discussed with a reference group.

Results: The search yielded 8477 unique studies, of which 22 met the inclusion criteria. The findings revealed persistent challenges over the past two decades. Most studies used qualitative methods, and the majority were conducted in a Scandinavian context. Written communication was the predominant collaborative activity reported in the studies. Barriers were more frequently identified than facilitators. Commonly reported barriers to successful collaboration included stereotyping, differing priorities, and an over-reliance on written communication. Facilitators included face-to-face meetings and high-quality written communication. Although facilitators have not been extensively studied, our findings emphasize the interconnection between barriers and facilitators, indicating that facilitators can provide strategies to address these barriers. Furthermore, we observed a lack of consensus in the literature regarding key concepts, such as'collaboration'.

Discussion: Based on the findings, we recommend that future research focus on achieving conceptual clarity and examining the underlying conditions that influence the potential for collaboration between general practice and sickness benefits offices in RTW processes.

Purpose: Spinal cord injury (SCI) is a life-altering condition that often results in varying degrees of sensory and motor impairment. In Saudi Arabia, SCI predominantly affects young individuals aged 16-30 years, disrupting their daily activities and limiting their participation in work and community life. Despite this, no prior research in Saudi Arabia has explored the experiences of individuals with SCI regarding returning to work (RTW) or how they manage the long-term impacts of their disability. This study aimed to explore the lived experiences of returning to employment amongst individuals with SCI in Saudi Arabia.

Methods: A qualitative study design was employed using interpretative phenomenological analysis. Semi-structured interviews lasting 45-90 min were conducted with three individuals living with SCI. Data were analysed following the IPA framework outlined by Smith et al. (2009).

Results: Six themes emerged from the analysis: employment history, RTW barriers, RTW facilitators, personal factors, community, and RTW itself.

Conclusion: The RTW experience of individuals with SCI in Saudi Arabia is shaped by personal, social, and systemic factors. The individual's capacity for coping and problem-solving is central to this process. However, structural barriers and limited societal inclusion often lead to occupational injustice. There is an urgent need for policymakers and rehabilitation professionals to implement supportive frameworks that promote equitable work reintegration and community participation for people with SCI.

Purpose: Persons with disabilities can face challenges in obtaining high quality jobs during critical work transitions that are linked to worker well-being and opportunities for sustainable career growth. There is a need to identify and describe employment interventions that support persons living with disabilities in obtaining high quality jobs and advancing in their careers during critical work transitions.

Methods: A scoping review of published intervention research was conducted. Two parallel searches focusing on job quality and career advancement were carried out and merged. Articles were screened at the title and abstract level and at full text level by two reviewers. A narrative synthesis was undertaken to examine the impact of relevant interventions on job quality and career advancement during critical work transitions.

Results: Searches yielded 5858 studies (2543 job quality studies; 3315 career advancement studies). Fifteen studies were included from the job quality search and one study was included from the career advancement search. Studies originated from 3 different countries, the most prevalent being the United States of America (n = 14). Eight studies focussed on vocational rehabilitation interventions, six focused on interventions at post-secondary educational settings, one study focused on individualized placement services and two focussed on customised employment. The included studies offered limited measurements of job quality outcomes and career advancement. Vocational rehabilitation interventions were promising for enhancing job quality at the early career phase, particularly when delivered within educational institutions.

Conclusion: Overall, evidence is lacking on the interventions that promote job quality and career advancement at different phases of the working life course. Additional research is needed to develop applied insights that enhance current programs, ensuring persons with disabilities can navigate career transitions and to promote job quality and career advancement.

Purpose: The aim of this study was to examine the length of waiting time in elective knee, shoulder, hip, and lower back surgery, and how it was associated with sickness absence, use of health care, and work ability support services during 1 year after the surgery.

Methods: The patients (n = 429) were grouped by the elective surgery they had undergone. Waiting time was calculated as the time between the day of referral and the day of operation. The register data were analyzed with general linear regression.

Results: The median waiting time for a knee operation (n = 287) was 98 days, for a shoulder operation (n = 105) 39 days, for a hip operation (n = 19), 177 days and for a lower back operation (n = 18) 114 days. The use of work ability support services increased after all the operations. A prolonged waiting time (> 90 days) for knee and shoulder operations was associated with the amount of sickness absence (IRR: 1.09, 95% CI 1.06-1.12; IRR: 0.86, 95% CI 0.82-0.89, respectively), secondary health care visits (IRR: 1.81, 95% CI 1.33-2.47; IRR: 2.28, 95% CI 1.50-3.47, respectively), and occupational curative care visits (IRR: 2.06, 95% CI 1.30-3.29) for shoulder operations. No association was found between a prolonged waiting time and work ability service visits during the year after the surgery.

Conclusion: The association of waiting time length with postoperative sickness absences and health care visits calls for taking actions to reduce the waiting times. Waiting should be considered as an active time aiming to prepare for the operation and the recovery.

Purpose: Return-to-work (RTW) counseling is a critical part of rehabilitation of sick-listed employees with common mental disorders (CMD). In the Netherlands it is mandatory that RTW counseling with an occupational physician (OP) starts within two weeks, but current literature and guidelines provide little empiric support. This study aims to answer the questions "Is starting RTW counseling within two weeks associated with faster RTW?" and "Is there a dose-response effect (i.e. the earlier the better)?".

Methods: In an observational design, sick-listed employees (n = 12,169) seen by an OP within two weeks of onset of sick leave were compared to those seen later using Cox proportional hazards analysis. Next, per week effects were examined, reporting pairwise comparisons of weeks 1 through 6 if the omnibus test was significant.

Results: Earlier RTW counseling was associated with earlier RTW (HR: 0.89, 95%CI: 0.86-0.93). There was a dose-response effect (LLR χ²: 46.08, df = 5, p < 0.001) with significant earlier RTW when RTW counseling was started in week 1 versus week 3 (HR: 0.90(95%CI 0.85-0.96), p < 0.001), week 1 versus week 5 (HR: 0.88(95%CI 0.81-0.94), p < 0.001), week 1 versus week 6 (HR: 0.82(95%CI 0.77-0.88), p < 0.001), and week 2 versus week 6 (HR: 0.84(95%CI 0.79-0.89), p < 0.001). However, subgroup analyses showed these findings only held for employees with adjustment disorders.

Conclusions: There is a modest benefit to starting RTW counseling earlier. However, this effect is limited to those seen very early and there are no significant differences between weeks 2 through 5. Whether these modest benefits warrant strict adherence to a two-week deadline should be re-evaluated.

Objective: To evaluate the influence of a mental health treatment program for public safety personnel (PSP) disabled by post-traumatic stress disorder (PTSD) on return-to-work outcomes.

Methods: A mental health treatment program established exclusively for PSPs disabled by work-related PTSD received 582 referrals over the period November 2021 to June 2023. Return-to-work outcomes were defined as the cessation of workers' compensation wage replacement benefits over an 18-36 month period following referral. Outcomes among the referral cohort were compared to PSPs not referred to treatment who also had an accepted workers' compensation claim for PTSD. Referrals were matched to non-referrals on age, sex, occupation and date of injury.

Results: Among the 472 referrals to the treatment program eligible for inclusion in the study, 54.4% initiated treatment. There was no difference in return-to-work outcomes over the follow-up period between the referrals who initiated treatment (29.9%) and the 215 referrals not initiating treatment (32.5%, p = 0.612). In contrast, return-to-work outcomes were more positive among the matched non-referral comparison group (41.9%, p < 0.001, all referrals vs the matched non-referral comparison group).

Conclusion: In this large cohort of PSPs disabled by PTSD, there was no evidence of a positive treatment effect on return-to-work outcomes. The prognosis for return-to-work among public safety personnel with long durations of recovery from PTSD is poor. The implications of this study point to the importance of the development and testing of novel evidence-based treatments and opportunities to support employers' commitment and capacity to provide suitable accommodation as strategies to improve return-to-work outcomes among public safety personnel disabled by PTSD.

Aim: Enhancing the adaptability to return to work among cancer patients can help them fully mobilize coping resources and adapt to the environment during the reintegration process. However, influenced by multiple factors, the adaptability to return to work among cancer patients in China remains inadequate and requires improvement. To address this, we aim to develop and validate the Questionnaire of Factors related to the Adaptability to Return to Work Among Cancer Patients (abbreviated as QF-ARTWCP). Grounded in the theoretical model "Cancer Patients' Return-to-Work Adaptation Experience and Coping Resources," social ecosystems theory, and social support theory, this instrument will provide a foundation for subsequent investigations and the development of targeted intervention programs.

Methods: The development of the QF-ARTWCP was conducted in three phases: (1) Item generation: A literature review identified relevant influencing factors and existing evaluation tools. This was followed by three rounds of experts consultations (15 experts) and a pilot survey (30 patients), resulting in a 59-item initial questionnaire; (2) Preliminary survey: Item analysis, exploratory factor analysis (EFA), and reliability testing were performed with 238 participants. Content validity was assessed by 8 experts; and (3) Formal verification investigation: Confirmatory Factor Analysis (CFA) using fit indices (e.g., χ²/df, RMSEA, SRMR) evaluated model-data fit. Convergent validity was quantified via average variance extracted (AVE), and composite reliability (CR), with 277 participants.

Results: The final QF-ARTWCP consists of 34 items across nine factors: Healthy Cognition; Work Cognition; Emotional Coping; Work Coping; Unit Support; Support from Friends and Relatives, Financial Burden; Social Atmosphere; and Policy Support. The CFA demonstrated acceptable model fit (χ²/df = 2.245, P < 0.001; RMSEA = 0.067, SRMR = 0.052; CFI = 0.914, and TLI = 0.902. Additionally, the AVE (0.615-0.792) and CR (0.834-0.938) values indicated strong aggregate validity.

Discussion: The QF-ARTWCP is a validated, user-friendly tool tailored for cancer patients. This questionnaire enables the evaluation and monitoring of the adaptability to return to work in occupational settings, supporting targeted interventions.

Purpose: Trust is key to a successful return to work following a work disability. Its constituents, which have been widely documented in social and management sciences research, are not addressed in return to work (RTW) research. This study therefore aims to portray the constituents of trust that have been documented in the context of RTW following an absence due to musculoskeletal disorder or a common mental disorder.

Method: A scoping review was performed using Joanna Briggs Institute methodology and the PRISMA extension for scoping review guidelines. Studies were extracted from six databases using keywords like trust, RTW/disability, and musculoskeletal/common mental disorders. Study selection and analysis were conducted in Covidence by two reviewers independently. An Excel framework served to record the constituents of trust (i.e., antecedents, attributes, and consequences) identified in accordance with a thematic analysis approach.

Results: From the 2795 references extracted, 30 studies were selected, 73% of which were published in the Last 10 years. All three constituents were documented, mainly in the dyadic relationship between the worker returning to work and other stakeholders. Yet, some known antecedents of trust remain underexplored and new consequences emerge. Support also appears to be both an antecedent and a consequence, which encourages reflection on the possibility of trust reciprocity.

Conclusion: While the constituents of trust involved in RTW were documented, they should be tested empirically, and some constituents and relationships need further exploration. Recommendations to improve trust between stakeholders are proposed.

Purpose: Physiotherapists play a central role in the rehabilitation of individuals with work-related musculoskeletal disorders. Yet, it is currently unclear how entry-level training prepares them to manage work disability. This study aimed to (1) identify a set of work rehabilitation competencies, (2) examine how these competencies are integrated into entry-level physiotherapy training programs in Quebec, Canada, and (3) assess educators' perceptions of the adequacy of work rehabilitation education.

Methods: A five-step consensus-building process with engaged partners and a literature review served to identify the competencies. Subsequently, educators from all Quebec physiotherapy programs completed a cross-sectional survey containing closed- and open-ended questions. The survey documented the integration of general and competency-specific work rehabilitation content and educators' ratings of students' preparedness for entry-to-practice for each competency. Quantitative data were analyzed descriptively, and open-text responses were analyzed using qualitative metasummary.

Results: Seven work rehabilitation competencies were identified and used to structure the survey. The median time dedicated to work rehabilitation education was 5.5 h (range 1-21.5). Programs partially integrated the competencies, using mostly didactic learning strategies. Coverage of key topics for each competency and relevance to work rehabilitation varied considerably across programs. Educators reported low student preparedness for competencies requiring work-focused knowledge and skills and varying comfort with teaching this content.

Conclusion: This study highlights critical gaps in physiotherapy education related to work rehabilitation and provides a benchmark for how key competencies are addressed in Quebec programs. These findings offer a foundation for improving work rehabilitation training for physiotherapists.

Purpose: This study investigates factors associated with receiving return-to-work (RTW) coordination within primary healthcare and the association between received RTW coordination and the amount of sickness absence (SA) days.

Methods: This register study included 13019 people who had SA at some time between March 2019 and February 2020 and visited a primary healthcare clinic that employed a RTW coordinator. Logistic regressions were used to investigate received RTW coordination. Negative binomial regressions were used to analyse the amount of SA days in the ten-month follow-up period.

Results: Associations were found between receiving RTW coordination and being a woman, being 30-49 years old, and having higher educational attainment, more healthcare contacts, more SA days, and a musculoskeletal or mental diagnosis. In the following ten-month period, mean SA were 71.3 days among people receiving RTW coordination and 76.1 days for those who had not. However, the adjusted analyses did not show association between RTW coordination in primary healthcare and the amount of SA days in the following ten-month period.

Conclusion: RTW coordination seems to be directed towards some groups of people with a higher risk of long-term SA, but not all, which raises the question of whether or not more people on SA would have benefited from RTW coordination as well. This would likely mean that more finely calibrated ways of identifying people at risk of long-term SA are needed. The reduction in SA days for those who had received RTW coordination needs to be confirmed in further studies.