Reverse Malingering— Staying on the Job at Any Cost
ABSTRACT Reverse malingering in the workplace is not as common as malingering. Despite their injuries, some workers will stay at work for various reasons regardless of the potential for further injury. Employers must be aware of reverse malingering and should consider alternative work assignments that will satisfy themselves and employees. [Workplace Health Saf 2013;61(7):297-298.].
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ABSTRACT: The occurrence of major depressive disorder (MDD) among military pilots and navigators poses questions with respect to medical care and waiver policy, but the prevalence of such disorders is unclear. We studied the epidemiology of MDD in a USAF aircrew population. The occurrence of MDD was determined for the period 2001-2006 using the USAF Aeromedical Information Management Waiver Tracking System, which records medical disqualifications and waivers for the entire population of both qualified and disqualified (grounded) USAF aviators. The mean annual population of USAF pilots and navigators averaged 17,781 during the study period. The database yielded 51 cases of MDD, of which 8 were recurrent and 43 were single episodes. All of the recurrent cases were disqualified, while 18 of the single-episode cases (42%) received a flying waiver after being asymptomatic without medications for at least 6 mo. Estimated annual MDD prevalence was 0.06% for the study population. In comparison, the annual prevalence of MDD is 6.7% in the general U.S. population, 2.8% among groups of executives and 4.1% among professionals. Odds ratios were 128 (68,238), 51 (27,96), and 76 (41,142) for the general population, executives, and professionals, respectively. Annual MDD prevalence among USAF pilots and navigators was significantly lower than that of the general U.S. population. The difference may reflect lower aircrew vulnerability to depression because of selection and training processes or lower rates of self-report and treatment due to feared aeromedical and/or career consequences.Aviation Space and Environmental Medicine 09/2009; 80(8):734-7. DOI:10.3357/ASEM.2484.2009 · 0.78 Impact Factor
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ABSTRACT: Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators) and how they manage to maintain working (success factors). A semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?" A total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs. Personal characteristics, well-developed self-management skills, and motivation to work may be considered to be important success factors and prerequisites for staying at work, resulting in behaviors promoting staying at work such as: raising adjustment latitude, changing pain-coping strategies, organizing modifications and conditions at work, finding access to healthcare services, and asking for support. Motivators and success factors for staying at work may be used for interventions in rehabilitation and occupational medicine, to prevent absenteeism, or to promote a sustainable return to work. This qualitative study has evoked new hypotheses about staying at work; quantitative studies on staying at work are needed to obtain further evidence.BMC Musculoskeletal Disorders 06/2011; 12:126. DOI:10.1186/1471-2474-12-126 · 1.90 Impact Factor