Outpatient rehabilitation of workers with musculoskeletal disorders using structured workplace description.
ABSTRACT In most industrialized countries musculoskeletal disorders contribute considerably (25%) to illness induced work absence. A special interest to reduce worker absences exists in highly specialized industries such as jet manufacturing, where specific knowledge is hard to replace. We investigated the reduction and sustainability in sick leave days by a workplace oriented outpatient rehabilitation program based on structured information exchange between occupational physicians and therapists.
Sick leave days reduction and return-to-work-ratios were analysed for 79 male blue collar workers with musculoskeletal disease, who voluntarily participated in an outpatient rehabilitation treatment between 2002 and 2005. During rehabilitation therapy standardized workplace descriptions were given to the therapists and individual return-to-work (rtw) schemes were implemented. Therapy lasted from 3 to 4 weeks followed by workplace reintegration. Off-work-time was calculated from 0 to 6 years before and 0 to 3 years after rehabilitation from insurance and industrial medical reports.
A total of 97% of the patients returned to their original job at the workplace, usually directly after the rehabilitation. Average sick leave days per year were reduced from 48.8 +/- 32.8 days before to 34.2 +/- 37.3 days after the rehabilitation. The therapy interrupted an increase in sick leave days over the years stabilizing absence at a low level for at least 2 years. Duration of illness related work absence was the only significant predictor for sick leave reduction (P < 0.05). Other common risk factors for musculoskeletal diseases like smoking or body mass index did not significantly influence the therapeutic effect.
Our results support evidence that information exchange for workplace description and rehabilitation therapist may help to reduce sick leave days and achieve very high rtw-ratio. However it is important to observe the effects of this shared information for longer intervals.
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ABSTRACT: Introduction Work-related injury is a major public health problem and a worker's recovery can be shaped by their interactions with employers, healthcare providers and the workers' compensation system. Most research on the effects of compensation has concentrated on examining outcomes rather than considering the compensation process itself. There has been little attention paid to the interactions between stakeholders and only recently has the client's view been considered as worthy of investigation. This systematic review aimed to identify and synthesize findings from peer reviewed qualitative studies that investigated injured workers interactions with insurers in workers' compensation systems. Method A search of six electronic library databases revealed 1,006 articles. After screening for relevance, 18 articles were read in full and a search of those bibliographies revealed a further nine relevant articles. Quality assessment of the 27 studies resulted in a final 13 articles of medium and high quality being retained for data extraction. Results Included studies focused mainly on experiences of injured workers, many of whom had long term claims. Findings were synthesized using a meta-ethnographic approach. Six themes were identified which characterised the interactions between insurers and injured workers. The majority of interactions were negative and resulted in considerable psychosocial consequences for injured workers. Positive interactions were less frequently reported and included respectful, understanding and supportive communication and efficient service from insurers. Conclusion Findings from this synthesis support the growing consensus that involvement in compensation systems contributes to poorer outcomes for claimants. Interactions between insurers and injured workers were interwoven in cyclical and pathogenic relationships, which influence the development of secondary injury in the form of psychosocial consequences instead of fostering recovery of injured workers. This review suggests that further research is required to investigate positive interactions and identify mechanisms to better support and prevent secondary psychosocial harm to injured workers.Journal of Occupational Rehabilitation 05/2014; 25(1). DOI:10.1007/s10926-014-9513-x · 2.80 Impact Factor
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ABSTRACT: Introduction In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW interventions that generally facilitate return to work (i.e. in multiple target populations and across interventions). This type of knowledge is highly relevant to policy makers and health practitioners who want to deliver evidence based care that supports the employee's health and participation in labour. Methods We performed a keyword search (systematic literature review) in seven databases (period: 1994-2010). In total, 23 articles were included and assessed for their methodological quality. The characteristics of the interventions were evaluated as well. Results Early interventions, initiated in the first 6 weeks of the RTW process were scarce. These were effective to support RTW though. Multidisciplinary interventions appeared effective to support RTW in multiple target groups (e.g. back pain and adjustment disorders). Time contingent interventions in which activities followed a pre-defined schedule were effective in all physical complaints studied in this review. Activating interventions such as gradual RTW were effective in physical complaints. They have not been studied for people with psychological complaints. Conclusions Early- and multidisciplinary intervention and time-contingent-, activating interventions appear most effective to support RTW.Journal of Occupational Rehabilitation 04/2012; 22(4). DOI:10.1007/s10926-012-9359-z · 2.80 Impact FactorThis article is viewable in ResearchGate's enriched formatRG Format enables you to read in context with side-by-side figures, citations, and feedback from experts in your field.
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ABSTRACT: PURPOSE: Systematic collaboration between occupational physicians (OPs) and rehabilitation physicians (RPs) can improve occupational rehabilitation processes and outcomes. The JobReha discharge letter (JR-DL) is a key element of JobReha, a multilevel intervention for specific occupational rehabilitation of workers with musculoskeletal disorders. This feasibility study aims to analyse the perceived benefit and acceptance of the JR-DL as an instrument for improving the communication interface between RPs and OPs. METHODS: On the day of discharge from rehabilitation, the rehabilitation physician completed a JR-DL form containing relevant information on the rehabilitation measures undertaken during treatment and recommendations for return to work. The JR-DL was either transmitted to the patient's occupational physician directly or given to the patients to bring to the OP to support the reintegration process. The JR-DL as an instrument for improving the communication interface was evaluated using data from patient questionnaires (n = 250), JR-DLs (n = 247), OP questionnaires (n = 224) and RP questionnaires (n = 232). RESULTS: All rehabilitation physicians sent a JR-DL to the respective occupational physician on the day of discharge. OPs received the reports a median 2 days after discharge. The content quality and relevance of the JR-DL for the reintegration process were rated high to moderate by more than 97.0 % of the OPs; 92.3 % of the patients received a recommendation to return to their previous workplace; 43.3 % returned with minor limitation; and the remaining 31.6 % with a recommendation for individual reintegration; 74.0 % of the workers returned to work within 3 days of discharge. CONCLUSIONS: Use of the JR-DL for the improvement of communication and exchange of relevant information is feasible and supportive for both rehabilitation and occupational physicians. Its positive impact on reintegration and return to work was apparent. Delays in receipt of the JR-DL should be eliminated by appropriate quality assurance measures.International Archives of Occupational and Environmental Health 08/2012; 86(6). DOI:10.1007/s00420-012-0805-1 · 2.10 Impact Factor