Journal of Occupational Rehabilitation (J Occup Rehabil)

Publications in this journal

• Article: Are the Predictors of Work Absence Following a Work-Related Injury Similar for Musculoskeletal and Mental Health Claims?

  Peter M Smith, Oliver Black, Tessa Keegel, Alex Collie
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  ABSTRACT: Objective To examine if the factors associated with days of absence following a work-related injury are similar for mental health versus musculoskeletal (MSK) conditions. Methods A secondary analysis of wage replacement workers' compensation claims in the state of Victoria, Australia. We examined the relationship between individual, injury, occupational and workplace variables with days of wage replacement over the 2-year period following first day of absence from work separately for mental health claims and MSK claims using negative binomial regression models. Results Mental health conditions were associated with a greater number of days of absence over the 2 years following first incapacity compared to MSK conditions. Differences were observed in employment, injury and industry variables on absence from work for mental claims compared to MSK claims. Working in the agriculture, forestry, fishing and mining industries and employment with a small organisation were more strongly associated with the number of days of wage-replacement among MSK compared to mental health claims, and working in the public administration and safety, or education and training industries or being employed in a position with high time pressure were associated with greater days of wage-replacement among mental health compared to MSK claims. Conclusions Predictors of days away from work in the 2 years following an injury differ for mental health versus MSK claims. Given the increasing number of mental health claims in Australia more research is required to understand differences in return-to-work for this group of claimants compared to those with physical injuries.
  Journal of Occupational Rehabilitation 06/2013;
• Article: Effect Evaluation of a Self-Management Program for Dutch Workers with a Chronic Somatic Disease: A Randomized Controlled Trial.

  S I Detaille, Y F Heerkens, J A Engels, J W J van der Gulden, F J H van Dijk
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  ABSTRACT: Purpose The objective of this study is to investigate the effect of a Self-Management Program for workers with a chronic disease. This program is based on the Chronic Disease Self-Management Program of Stanford University, modified for workers with a chronic somatic disease. Methods In a randomized controlled trial, the effectiveness of a Self-Management Program was evaluated. Participants were randomly assigned to the experimental group (n = 57) and the control group (n = 47). The experimental group received an intervention, the control group received care as usual. Primary outcome measures were self-efficacy at work and the attitude towards self-management at work. Secondary outcomes were the SF-12 health survey questionnaire, job satisfaction and intention to change job. The results were measured at baseline, after the intervention and 8 months after the intervention. Results The attitude towards self-management at work (enjoyment) improved after 8 months for the intervention group (p = 0.030). No other outcome variable differed significantly. As an interaction effect, it was found that low educated workers developed a better physical health quality (SF-12) in the intervention group compared with the control group. The attitude towards self-management at work (importance) improved in the intervention group for older and female workers and the attitude toward enjoying self-management at work improved for female workers only. Conclusion The results show that low educated workers, older workers and women benefit significantly more from the training than higher educated workers, younger workers and men.
  Journal of Occupational Rehabilitation 05/2013;
• Article: How to Engage Occupational Physicians in Recruitment of Research Participants: A Mixed-Methods Study of Challenges and Opportunities.

  Iris Arends, Ute Bültmann, William S Shaw, Willem van Rhenen, Corné Roelen, Karina Nielsen, Jac J L van der Klink
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  ABSTRACT: Purpose To investigate barriers and facilitators for research participant recruitment by occupational physicians (OPs). Methods A mixed-methods approach was used. Focus groups and interviews were conducted with OPs to explore perceived barriers and facilitators for recruitment. Based on data of a cluster-randomised controlled trial (cluster-RCT), univariate and multivariate analyses were conducted to investigate associations between OPs' personal and work characteristics and the number of recruited participants for the cluster-RCT per OP. Results Perceived barriers and facilitators for recruitment were categorised into: study characteristics (e.g. concise inclusion criteria); study population characteristics; OP's attention; OP's workload; context (e.g. working at different locations); and OP's characteristics (e.g. motivated to help). Important facilitators were encouragement by colleagues and reminders by information technology tools. Multivariate analyses showed that the number of OPs within the clinical unit who recruited participants was positively associated with the number of recruited participants per OP [rate ratio of 1.43, 95 % confidence interval 1.24-1.64]. Conclusions When mobilising OPs for participant recruitment, researchers need to engage entire clinical units rather than approach OPs on an individual basis. OPs consider regular communication, especially face-to-face contact and information technology tools serving as reminders, as helpful.
  Journal of Occupational Rehabilitation 05/2013;
• Article: A Classification of Components of Workplace Disability Management Programs: Results from a Systematic Review.

  U Gensby, M Labriola, E Irvin, B C Amick, T Lund
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  ABSTRACT: Purpose: This paper presents results from a Campbell systematic review on the nature and effectiveness of workplace disability management programs (WPDM) promoting return to work (RTW), as implemented and practiced by employers. A classification of WPDM program components, based on the review results, is proposed. Methods: Twelve databases were searched between 1948 to July 2010 for peer-reviewed studies of WPDM programs provided by employers to re-entering workers with occupational or non-occupational illnesses or injuries. Screening of articles, risk of bias assessment and data extraction were conducted in pairs of reviewers. Studies were clustered around various dimensions of the design and context of programs. Results: 16,932 records were identified by the initial search. 599 papers were assessed for relevance. Thirteen studies met inclusion criteria. Twelve peer reviewed articles (two non-randomized studies, and ten single group experimental before and after studies), including ten different WPDM programs informed the synthesis of results. Narrative descriptions of the included program characteristics provided insight on program scope, components, procedures and human resources involved. However, there were insufficient data on the characteristics of the sample and the effect sizes were uncertain. A taxonomy classifying policies and practices around WPDM programs is proposed. Conclusion: There is insufficient evidence to draw conclusions on the effectiveness of employer provided WPDM programs promoting RTW. It was not possible to determine if specific program components or specific sets of components are driving effectiveness. The proposed taxonomy may guide future WPDM program evaluation and clarify the setup of programs offered to identify gaps in existing company strategies.
  Journal of Occupational Rehabilitation 05/2013;
• Article: How Persons with a Neuromuscular Disease Perceive Employment Participation: A Qualitative Study.

  Marie-Antoinette H Minis, Ton Satink, Astrid Kinébanian, Josephine A Engels, Yvonne F Heerkens, Baziel G M van Engelen, Maria W G Nijhuis-van der Sanden
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  ABSTRACT: Introduction A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. Methods 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant comparison method. Results Four themes were identified in the analyses: (1) Experiences regarding the meaning of work; (2) Solving problems oneself; (3) Reaching a turning point; and (4) Taking into account environmental aspects. Persons with NMD highlighted benefits of staying at work as well as the tension they felt how to shape decisions to handle progressive physical hindrances in job retention. This study shows how participants at work with NMD were challenged to keep up appearances at work and at home, the tension felt around when and if to disclose, the effect of their condition on colleagues and work reorganisation challenges. Participants experienced that disclosure did not always make things better. With increasing disability participants' focus shifted from the importance of assistive products towards considerate colleague, in particular superior's willingness in supporting job retention. Conclusions Implications for health professionals might include awareness of the significant impact of changes in physical condition on employment. Timely communication and if appropriate referral to a health or occupational professional may empower employees with NMD to handle employment issues at a for themselves appropriate way. Assistive products and a supportive superior might enhance employment participation.
  Journal of Occupational Rehabilitation 05/2013;
• Article: Improved Occupational Performance of Young Adults with a Physical Disability After a Vocational Rehabilitation Intervention.

  Joan A C Verhoef, Marij E Roebroeck, Natascha van Schaardenburgh, Monique C S G Floothuis, Harald S Miedema
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  ABSTRACT: Purpose The purpose of this study was to investigate into more detail how occupational performance of participants of a 1-year multidisciplinary vocational rehabilitation intervention changed over time, using a broad focus on three areas of occupational performance, addressing work, as well as self-care and leisure. In addition, we explored differences between employed and unemployed persons. Methods In a pre-post-intervention design, changes in occupational performance, addressing work, self-care and leisure, were evaluated using the Canadian Occupational Performance Measure (COPM) and the Occupational Performance History Interview (OPHI-II). Results Eleven young adults (median 22 years) with physical disabilities participated. Post-intervention, participants experienced fewer problems and showed improved occupational performance in work, as well as self-care and leisure, and improved satisfaction with performance. Participants also showed improved occupational identity and occupational competence, and total scores on OPHI-II. Participants who did not achieve employment did not differ in demographic characteristics. They experienced problems in all three areas of occupational performance at pre-intervention, and more difficulty in interacting in occupational settings (environment). Post-intervention, their levels of occupational identity, competence and settings were similar to those of employed persons. Conclusions Participants showed improved occupational performance after the intervention. The goal of employment and the broad integrated approach of the intervention seemed to motivate participants to resolve problems in work, as well as self-care and leisure. Unemployed persons faced problems in all three areas of occupational performance at start. Although they seemed to catch up during the intervention, they did not achieve employment within 1 year.
  Journal of Occupational Rehabilitation 04/2013;
• Article: The Association between Workers' Compensation Claims Involving Neck Pain and Future Health Care Utilization: A Population-based Cohort Study.

  Pierre Côté, Xiaoqing Yang, Vicki Kristman, Sheilah Hogg-Johnson, Dwayne Van Eerd, Mana Rezai, Marjan Vidmar
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  ABSTRACT: Purpose To describe the health care utilization of injured workers who made a workers' compensation claim for neck pain. Methods. We conducted a cohort study of injured workers who made an incident claim involving neck pain to the Ontario Workplace Safety and Insurance Board between 1997 and 1998. We linked their workers' compensation and Ontario Health Insurance Plan files to collect all health care services accrued during the year prior to and 2 years after the claim was initiated. We report the 7 day simple moving average of health care services per 1,000 claimants per day. We stratified our analysis by age, sex, the pre-claim level of health care utilization, diagnostic category and health care specialty. Results 58.1 % of claimants were males and 35.1 % were between the ages of 35 and 44 years. The cumulative rate of health care utilization was stable (mean = 60.80 services/1,000 claimants/day; 95 % CI: 59.7-62.0) throughout the year prior to the claim. However, it peaked during the first 4 days following the onset of the claim (mean = 473.3 services/1,000 claimants/day) and remained on average 311 % higher than baseline during the first month post-claim. On average in our sample, the health care utilization remained 11 % higher in the second year after the claim compared to the pre-claim level. This sustained increase was attributable to 6 % of claimants. Conclusions We report a long-term increase in the average number of health care services utilized by injured workers who make a workers' compensation claim involving neck pain. This increase was attributable to a minority of claimants. The health reasons for this increase deserve further investigation.
  Journal of Occupational Rehabilitation 04/2013;
• Article: How Well Do We Report on Compensation Systems in Studies of Return to Work: A Systematic Review.

  Fiona J Clay, Janneke Berecki-Gisolf, Alex Collie
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  ABSTRACT: Purpose Occupational injury and work-related disability is a significant public health problem. For published research to provide a collective knowledge base for return to work (RTW) policy and practice, features of the compensation system relevant to the research must be described clearly. The level of the reporting on compensation system features is yet to be established. The aim of the present study was to synthesize the evidence for the reporting on compensation systems in prognostic studies of RTW following work-related injuries. Methods A systematic review of the literature was conducted. Ovid Medline and EMBASE were searched for studies published 1996-2011. Included studies were prognostic studies of RTW or work disability following work-related acute traumatic injuries. Results The initial search yielded 952 articles; 37 articles fulfilled the inclusion criteria. The majority of studies were based on clinical practice; eight studies were based on administrative data. Only two studies reported seven or more compensation features and two studies reported four to six. The majority of studies (19/37) did not report on any aspect of the compensation system that study participants were interacting with. The most common information reported was the extent of coverage at the population level (7/37) and the availability of wage replacement entitlements (7/37). The name of the compensation system was provided in 5 studies. Conclusions Overall reporting on compensation systems in prognostic studies of RTW needs to be improved if research evidence is to inform policy and practice. Compensation system features that could be reported are provided.
  Journal of Occupational Rehabilitation 04/2013;
• Article: Does the Knowledge-to-Action (KTA) Framework Facilitate Physical Demands Analysis Development for Firefighter Injury Management and Return-to-Work Planning?

  Kathryn Sinden, Joy C Macdermid
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  ABSTRACT: Purpose Employers are tasked with developing injury management and return-to-work (RTW) programs in response to occupational health and safety policies. Physical demands analyses (PDAs) are the cornerstone of injury management and RTW development. Synthesizing and contextualizing policy knowledge for use in occupational program development, including PDAs, is challenging due to multiple stakeholder involvement. Few studies have used a knowledge translation theoretical framework to facilitate policy-based interventions in occupational contexts. The primary aim of this case study was to identify how constructs of the knowledge-to-action (KTA) framework were reflected in employer stakeholder-researcher collaborations during development of a firefighter PDA. Methods Four stakeholder meetings were conducted with employee participants who had experience using PDAs in their occupational role. Directed content analysis informed analyses of meeting minutes, stakeholder views and personal reflections recorded throughout the case. Results Existing knowledge sources including local data, stakeholder experiences, policies and priorities were synthesized and tailored to develop a PDA in response to the barriers and facilitators identified by the firefighters. The flexibility of the KTA framework and synthesis of multiple knowledge sources were identified strengths. The KTA Action cycle was useful in directing the overall process but insufficient for directing the specific aspects of PDA development. Integration of specific PDA guidelines into the process provided explicit direction on best practices in tailoring the PDA and knowledge synthesis. Although the themes of the KTA framework were confirmed in our analysis, order modification of the KTA components was required. Despite a complex context with divergent perspectives successful implementation of a draft PDA was achieved. Conclusions The KTA framework facilitated knowledge synthesis and PDA development but specific standards and modifications to the KTA framework were needed to enhance process structure. Flexibility for modification and integration of PDA practice guidelines were identified as assets of the KTA framework during its application.
  Journal of Occupational Rehabilitation 04/2013;
• Article: Motivations of Persons with Psychiatric Disabilities to Work in Mental Health Peer Services: A Qualitative Study Using Self-Determination Theory.

  Galia Sharon Moran, Zlatka Russinova, Jung Yeon Yim, Catherine Sprague
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  ABSTRACT: Introduction Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Methods Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). Results External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. Conclusion This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers-a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental health peer providers.
  Journal of Occupational Rehabilitation 04/2013;
• Article: Validation of the Chinese Version of the Boston Carpal Tunnel Questionnaire.

  Yi-Jing Lue, Yen-Mou Lu, Gau-Tyan Lin, Ya-Fen Liu
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  ABSTRACT: Purpose Carpal tunnel syndrome (CTS) is a common diagnosis occurring in the workplace when people experience hand or wrist symptoms and difficulty performing activities. This study aimed to investigate the psychometric properties of the Chinese version of the Boston Carpal Tunnel Questionnaire (BCTQ) used to evaluate patients with CTS. Methods A convenience sample of patients with CTS was recruited from two hospitals. The Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ were used to assess symptoms and functional status. Test-retest reliability within 1 week was evaluated (n = 51). Construct validity was assessed by examining the relationship between the BCTQ and other well known measures (n = 99). Responsiveness of the scale was examined pre- and post-operatively for patients undergoing carpal tunnel surgery (n = 23). Results High reliability was demonstrated through intraclass correlation coefficients of 0.81 and 0.83 for SSS and FSS, respectively. The minimal detectable change was 0.86 and 0.75 for SSS and FSS, respectively. Convergent validity was supported by high correlation of both scales with Disability of the Arm, Shoulder and Hand (|rho| = 0.63, 0.75 for SSS and FSS), and moderate to high correlation with the subscales of the Short-Form 36 for SSS(|rho| = 0.72 for Body Pain) and FSS (|rho| = 0.48 for Physical Function). Responsiveness was confirmed by moderate to high standardized response means for SSS (1.03) and FSS (0.62). Conclusion The Chinese BCTQ is a reliable, valid and responsive disease-specific measure for assessment of symptoms and functional status in patients with CTS.
  Journal of Occupational Rehabilitation 04/2013;
• Article: Changes in Pain Catastrophizing Following Physical Therapy for Musculoskeletal Injury: The Influence of Depressive and Post-traumatic Stress Symptoms.

  Peter Slepian, Elena Bernier, Whitney Scott, Nils Georg Niederstrasser, Timothy Wideman, Michael Sullivan
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  ABSTRACT: Purpose: The aim of the present study was to investigate the factors that influence the change in pain catastrophizing during the course of a physical therapy intervention for musculoskeletal injury. Methods: 187 clients enrolled in a 7-week physical therapy intervention were divided into four mutually exclusive groups on the basis of a pre-treatment assessment: (1) clients whose pre-treatment catastrophizing scores and measures of mental health problems were below clinical threshold, (2) clients whose pre-treatment catastrophizing scores were above clinical threshold but who scores on measures of mental health problems were below clinical threshold, (3) clients whose pre-treatment catastrophizing scores were above clinical threshold and whose scores on measures of mental health problems were also above clinical threshold, and (4) clients whose pre-treatment catastrophizing scores were below clinical threshold but whose scores on measures of mental health problems were above clinical threshold. Results: The most prevalent risk profile consisted of clients with high levels of pain catastrophizing and high mental health problems (37 %), followed by the low catastrophizing and low mental health problems profile (35 %), the high catastrophizing and low mental health problems profile (16 %), and low catastrophizing and high mental health problems profile (10 %). Clients were considered non-responders if their post-treatment catastrophizing score remained above clinical threshold following treatment. Chi square analyses revealed a significantly higher proportion of non-responders in the high catastrophizing and mental health problem group than in any other group. Conclusions: The presence of mental health symptoms markedly reduces the effectiveness of physical therapy for reducing catastrophizing scores. The 'risk value' of high catastrophizing scores thus appears to vary as a function of the presence or absence of mental health symptoms. The findings argue for the inclusion of measures of mental health problems in the routine screening of individuals treated in physical therapy.
  Journal of Occupational Rehabilitation 03/2013;
• Article: What Work Means to People with Work Disability: A Scoping Review.

  S L Saunders, B Nedelec
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  ABSTRACT: Purpose: As paid work is the occupation that people spend the most amount of their time doing, it is an important provider of personal meaning in their lives. This meaning has been shown to vary from person to person and to be important to health and well being. When a person is unable to work due to a disabling condition, it is unclear whether this meaning remains or is replaced by other meanings. The purpose of this scoping review was to explore what was known in the existing literature on what work means to those with work disability. Methods: The review involved identifying and selecting relevant studies, charting the data and collating and summarizing the results. Results: Fifty-two studies explored the meaning of work for those with cancer, mental illness, musculoskeletal disorders, brain injuries, paraplegia, and AIDS. The studies revealed that, for most, work continued to be meaningful and important. Common themes across all types of disability included work being a source of identity, feelings of normality, financial support, and socialization. These meanings were found to be both motivating for return to work and health promoting. Conversely, a small number of studies found that the meanings and values ascribed to work changed following disability. New meanings, found either at home or in modified work, replaced the old and contributed to new identities. Conclusions: The exploration of the meaning of work has been shown to provide important understanding of the experience of work and disability. This understanding can guide rehabilitation professionals in their interventions with the work disabled.
  Journal of Occupational Rehabilitation 03/2013;