Journal of Occupational Rehabilitation最新文献

Purpose: To identify, appraise, and synthesize qualitative research evidence exploring patients' needs regarding work-focused healthcare.

Methods: A systematic review was conducted in accordance with the PRISMA statement guidelines to identify studies reporting patients' needs regarding work-focused healthcare. Four databases (MEDLINE, Embase, PsychInfo and Web of Science) were systematically searched from January 2000 until May 2023 and screened in duplicate by pairs of two reviewers. Inclusion criteria were qualitative data collection method, and patients' perspectives regarding healthcare focusing on work when experiencing work-related problems due to chronic medical conditions. Data extraction and synthesis was executed by means of an inductive thematic analysis approach. The quality of the included studies was assessed using the CASP Qualitative Study checklist. Confidence in the review findings was assessed through the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach.

Results: Out of 23,677 records, 97 qualitative studies were included. Needs regarding four main themes were identified: (1) Substantive guidance, which comprises the specific content of work-focused healthcare; (2) Clear and continuous process, which comprises clarification and optimization of the work-focused healthcare process; (3) Supportive attitude and behavior, which comprises a positive and supportive attitude and behavior from professionals towards the patients; and (4) Tailored approach, which comprises the delivery of tailored care to the individuals' needs. 17 subthemes were identified.

Conclusion: The broader insight in patients' needs in work-focused healthcare can help (occupational) healthcare professionals adopt a more patient-centred approach in practice.

Purpose: The decision whether to disclose a disability at work is complex. Drawing on communication theories, we examined disclosure decision-making and how workers with disabling health conditions prioritized information that could simultaneously encourage and discourage disclosure.

Methods: An online, cross-sectional survey asked workers with physical and mental health/cognitive conditions creating job limitations (i.e., disability) at work about the health impacts on their employment, their disclosure goals, preferences, support availability, workplace culture, work context, and demographic information. Descriptive, multivariate, and latent profile analyses were used.

Results: Participants were 591 workers (51% men, 48% women, 1% non-binary) with physical (41%), mental health/cognitive (24%), or both groups of conditions (35%). Forty-two percent of participants had not disclosed health information or needs to their supervisor. Six profiles of decision patterns were identified: (1) little health impact, supports available; (2) some health impacts, positive support appraisals; (3) some health impacts, uncertain what to do; (4) some health impacts, considerable personal concerns; (5) little health impact, few concerns, few supports available; and (6) considerable health impacts but perceives many risks to sharing. Disclosure decisions often prioritized personal goals, preferences, and workplace culture over health impacts and support availability. Profiles were differentiated by health condition type and work context.

Conclusion: Understanding how workers prioritize information when considering disclosing a disability at work has implications for organizational support practices and clinical efforts to support workers. It underscores that worker decisions go beyond health impacts and highlights the need for support resources to help workers address decision uncertainty and stress.

Purpose: Young workers face higher risks of workplace accidents, mental health issues, and physical strain. This scoping review aims to identify and summarize available research literature on barriers and facilitators to implementing workplace interventions to support young workers' safety, work environment and health.

Methods: We conducted a comprehensive search in bibliographic databases including PubMed, Web of Science and PsycInfo for articles published from 2007-2022. The PICO strategy guided the assessment of relevant studies and the bibliographical search for qualitative and mixed-method studies on interventions where (1) participants were young workers (mean age 15-29 years), (2) interventions were initiated and/or carried out at the workplace, and (3) barriers or facilitators to the implementation of interventions to support young workers' safety, work environment and health were described. We employed an iterative process to identify general thematic categories in the data.

Results: In total, 11 relevant studies were identified. Seven primary themes related to facilitators and barriers emerged from our analysis. Facilitators: fit the organizational context, organizational support, balance between efforts and gains, employee motivation, and employee involvement; Barriers: high workload and time pressure, shift work and irregular working hours.

Conclusion: There is a lack of intervention studies on young workers focusing on factors for implementation. The studies we find, reveal several factors to be aware of when designing and implementing interventions to support young workers' safety, work environment and health. The results emphasize a need for studies evaluating factors of importance for the successful implementation of workplace-based interventions among young workers.

Review registration: PROSPERO CRD42022324299 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324299 ).

Background: In response to rising unemployment rates among people with multiple sclerosis (PwMS) and poor working conditions in Latin America (LATAM), MS experts established the Quality-of-Life working group. This study aims to: (i) describe occupational outcomes and employment status among PwMS in LATAM; (ii) investigate the relationship between different levels of disability and ES; and (iii) Quantify accommodation use and explore potential clinical, cognitive, and sociodemographic predictors of job accommodations in LATAM.

Methods: A total of 86 PwMS were recruited from Argentina, Chile, Colombia, Mexico, and Paraguay, of whom 79 (91%) had a relapsing-remitting phenotype and 61 (70.9%) were women. The assessment protocol included the Brief Visual Memory Scale (BVMS), the Brief International Cognitive Assessment for MS (BICAMS), the MS Neuropsychology Screening Questionnaire, the Beck Depression Inventory II (BDI-II), the Fatigue Severity Scale (FSS), and a socioeconomic status (SES) survey.

Results: (i) Based on employment status characteristics, 47 PwMS (54.6%) were classified into the work-stable group, 18 PwMS (20.9%) into the work-challenged group, and 21 PwMS (24.4%) into the work-loss group, additionally clinical and sociodemographic characteristics are described. (ii) Hierarchical cluster analysis ranked PwMS into three groups based on cognitive and physical disability levels, showing that a lower level of disability was linked to a higher likelihood of maintaining stable employment. (iii) Job accommodations were predicted by greater self-awareness of cognitive impairment, higher socioeconomic status, higher education, and higher physical disability, all contributing to increased use of workplace accommodations.

Conclusion: Physical and neuropsychological disability increase the likelihood of being classified in the work-loss group, while factors such as self-awareness of cognitive impairment, socioeconomic status, level of disability, and education are associated with greater utilization of job accommodations. The work-loss rate among PwMS in LATAM was nearly three times higher than the general unemployment rate, underscoring the significant impact of MS on employment.

Purpose: This study aimed to define parsimonious, non-overlapping subgroups of employers based on perceived facilitators and challenges in retaining workers with physical disabilities. Additionally, we sought to compare company characteristics, disability-related supports and practices, and job accommodation provision across employer subgroups.

Methods: We conducted a cross-sectional observational study using an online survey among 2,000 employers in the United States. Data analysis included 1,641 employers who hired at least one worker with a physical disability. Data analysis methods included latent profile analysis, independent t test, and chi-square or Fisher's exact test.

Results: We identified two subgroups of employers, characterized by high facilitator (n = 360) and high challenge groups (n = 1,281). The high facilitator group consists of employers who perceive greater facilitators than challenges in retaining workers with disabilities, while the high challenge group consists of employers who perceive greater challenges than facilitators. A greater proportion of respondents in the high facilitator group were from service-providing companies, had fewer than 500 employees, and were CEOs or owners, compared to those in the high challenge group. Additionally, the high facilitator group reported higher rates of hiring workers with disabilities over the past 12 months, greater implementation of disability-related supports and practices, and greater provision of job accommodations than the high challenge group.

Conclusion: Employers can enhance the retention of workers with physical disabilities by promoting facilitators and addressing challenges, strengthening disability-related supports and practices, and providing job accommodations. Future research should validate these findings and develop targeted interventions.

Purpose: Well-designed vocational rehabilitation programs (VRPs) are needed to ensure that people with acquired physical disabilities (PAPD) receive the optimal support to return to work. The aim of our scoping review was to summarize the literature on both international and local VRPs that support PAPD to return to work.

Methods: We conducted a scoping review based on Arksey and O'Malley's framework. We searched databases (PubMed, CINAHL, and PsycINFO) throughout March 2023. To be included, studies must have been published in a peer-reviewed scientific journal, be available in the English language, and describe a VRP for PAPD. We added a grey literature search to better understand local VRPs. We summarized the VRPs' characteristics and services narratively.

Results: We screened 2894 citations and included 20 in our review. These 20 articles discussed 16 VRPs. We identified 46 unique service components and categorized them into six domains - vocational, physical, financial, social, psychological, and others. The vocational domain comprised the majority of components identified (n = 18, 40%). However, no VRPs were exactly alike.

Conclusion: VRPs facilitate PAPD to return to work via a range of services. Our review is useful for vocational rehabilitation providers to enhance existing VRPs or to design new ones. We recommend that VRPs offer a set of standardized services with the option of expanding services based on emerging needs of service users. Our scoping review provides a valuable evidence synthesis of the services offered within the field of vocational rehabilitation. Future research to better understand the effectiveness of VRPs is warranted.

Objectives: Mental health-related work disability has increased in Europe, despite efforts to promote individuals´ work ability. We examined individuals´ occupational status before and after a psychiatric disability pension (DP).

Methods: The study comprises individuals granted a DP for the first time between 2010 and 2012 in Finland (N = 18,373). We used modern methods to cluster the sequences of individuals´ occupational status before and after temporary (n = 8615) or permanent (n = 9758) psychiatric DP. We compared socioeconomic, illness and health care system-related factors between nine groups, formed by sequence analysis utilizing multinominal regression analysis.

Results: The analysis identified typical groups of temporary pensioners: after steady working careers, periods of unemployment and from mixed states. Severity of health and mental health problems, socioeconomic and occupational status, pension system-related factors as well as treatment or rehabilitation varied between the groups. Individuals with temporary DPs (tDP) appeared mainly to either remain disabled (74% of the study tDP) or return to the same status they had before disability: to work (17%) or unemployment (8%). A steady working career, high education and received psychotherapy and rehabilitation all promoted returning to work. Among young adults, severity of the illness and lack of occupational education were risk factors for long-term disability.

Conclusions: Among those with tDP, circles of disadvantage may exist. They relate to unemployment, poor mental and somatic heath, low education, poverty, and failure of rehabilitative efforts. Especially young adults with severe mental disorders require not only rehabilitation but also educational support.

Purpose: Approximately, 80% of sick leave involve workers dealing with a common mental disorder (CMD) or a musculoskeletal disorder (MSD). Upon returning to work (RTW), these workers may encounter challenges, including functional limitations at work. However, assessing these limitations is complex. This study aims to map existing questionnaires that evaluate functional limitations in individuals with CMD or MSD.

Methods: A scoping review was conducted following the methods of the Joanna Briggs Institute's (JBI) Scoping Reviews Methodology Group, utilizing five databases: ProQuest, EBSCO, Scopus, Cochrane, and PsycNET. Articles were included if they presented a questionnaire evaluating functional limitations or related concepts in individuals with CMD or MSD.

Results: A total of 541 articles were identified, with 6 articles selected after the screening process. The most frequently assessed dimensions in the selected questionnaires were physical (in 5 tools) and cognitive (in 3 tools). A thematic analysis was performed to develop a unified classification of dimensions and identify various types of functional limitations, addressing the inconsistent terminology across the questionnaires.

Conclusion: Physical limitations seem to be more objective and easier to assess than psychological limitations. Future research should focus on psychological limitations to enhance understanding among healthcare professionals and individuals with CMD or MSD.

Purpose: The use of alcohol, tobacco, and other drugs (ATOD) can impact workplace productivity. Whilst presenteeism has a greater impact on productivity than absenteeism, it is less visible and often receives less attention. Measuring ATOD-related presenteeism is important for identifying the impact of AOD use and evaluating workplace AOD interventions. However, there is no standard approach to determining ATOD-related presenteeism. The aim of this scoping review was therefore to identify and describe different approaches and instruments used to determine ATOD-related presenteeism.

Methods: A scoping review of publications up to and including December 2024 was undertaken across three major databases: Scopus, Ovid Medline, and the Latin-American and Caribbean System on Health Sciences (LILACS). The population was workers for whom ATOD-related presenteeism was reported, the concept was presenteeism, and the context was the workplace.

Results: The review included 27 original studies. The most common approach (n = 22 studies) was indirect, which involved examining differences in presenteeism between workers who did and did not use ATOD. Direct approaches-asking participants explicitly about their ATOD-related presenteeism-were less common (n = 5 studies) and focussed exclusively on alcohol. Across both approaches, there was substantial variation in instruments (n = 4 direct, n = 10 presenteeism, n = 18 ATOD), use of validated instruments, recall periods, and ways of reporting findings, which may compromise the interpretation and synthesis of studies.

Conclusion: This scoping review provides an evidence base for informing approach and instrument selection. It establishes the need for further research on the impact of different approaches and instruments on findings. This information is essential to encourage more rigorous and standardised approaches to determining ATOD-related presenteeism and evaluating workplace interventions.