Great changes have come about in the last decade regarding the organization of work. High technology and the steadily increasing ideology of technocracy has produced a profound effect on the organization of work in some workplaces. This effect has made the psychosocial and physical working environment tougher, especially for women. The results we are presenting here show that when dividing fishing factories into three technological stages; low technology, middle technology and high technology, the job strain was highest and the decision authority by the employee was lowest in the high technological factories. This even had an impact on health and on the atmosphere at the workplace, where the employees in the high technological factories were more likely to complain about several health problems as well as about low degrees of cheerfulness at the workplace and tiresome jobs. However, these same people were the most positive towards the implementation of the high technology and the new way of organizing their job that the technology introduced.
The aim of the study was to investigate whether assessing zest for work is a valuable approach in occupational health work. The term "zest for work" comes from the expression "zest for life" and can roughly be interpreted as the degree of enthusiasm and satisfaction with the present work situation. The measurements comprise three components: listing important factors for the feeling of zest for work, attitude rating and stating whether it is possible to have any influence over the listed factors. Included in this study were 5539 employees, mainly women. Low zest for work was associated with job strain and insufficient social support and imposed an increased risk for poor health for working and long spells of sick leave. The results support that assessing zest for work can be useful in occupational health work.
Occupational therapists play an important role in work rehabilitation in getting people with chronic disabilities back to work. The Worker Role Interview (WRI) is intended to detect psychosocial and environmental factors influencing the ability to return to work for injured or disabled workers. This study examined the psychometric properties of the recently modified German version (WRI-G, 10.0) in a population with work-related musculoskeletal disorders (MSD) in Switzerland.
Data were gathered from 20 participants with work-related MSD. The interviews were conducted face-to-face and videotaped. Five occupational therapists, trained in the use of the WRI-G, independently rated all 20 interview recordings following the official manual. Thus, 100 ratings were analysed by use of Rasch analysis to test construct validity and transform ordinal raw data into linear data (person locations) for interrater-reliability calculations.
All items fit the Rasch model, except the item 'perception of boss'. The final WRI-G, consisting of 15~items, showed good overall model fit (X2 = 54.66, p = 0.04); excellent person-separation reliability (PSI 0.91) and high inter-rater reliability (mean ICC 0.90).
Based on this sample, the WRI-G (10.0) is a valid and reliable instrument to assess psychosocial ability for return to work in a population with work-related MSD.
There is very little knowledge on the long-term outcomes of sickness absence. The aim was to investigate sickness absence and disability pensions over 11 years in a cohort of young persons initially long-term sick listed with back, neck, or shoulder diagnoses.
A prospective population-based cohort study of all 213 individuals in the Municipality of Linköping, Sweden, who in 1985 were aged 25-34 and had at least one new sick-leave spell > 28 days with such diagnoses.
More women (61%) than men fulfilled the inclusion criteria. In 1996, 22% of the cohort (14% of the men, 26% of the women) had been granted disability pension; 76% of these individuals with musculoskeletal and the rest with psychiatric diagnoses. Partial disability pension was granted to 59% of the women, 17% of the men. Women were more often granted temporary disability pension than men.
This proved to be a high-risk group for disability pension. There were large and somewhat unexpected gender differences regarding incidence and type of disability pension. It has been debated how soon physicians should be concerned about the risk of long-term disability regarding these diagnoses; at four or eight weeks of sickness absence - our results support the former, at least for women.
This case study is a report of a rehabilitative employment program that used trauma focused group treatment with individuals who suffered from Posttraumatic Stress Disorder (PTSD) post 9/11. The program was developed in order to assist them to return to the work force. These Individuals lost their jobs because of the 9/11 terrorist attack and experienced financial difficulty, yet because of their PTSD symptoms, had difficulty seeking employment. Individuals were selected for group treatment based on the presence of PTSD symptoms as measured by The Posttraumatic Stress Diagnostic Scale, an external locus of control determined by the Internal and External Locus of Control Scale, low self-esteem as per the Self-Efficacy Scale, and hopelessness, as assessed through the Hopelessness Scale. Additional assessments (Role Checklist, Psychiatric Rehabilitation Determination, Vocational Sentence Completion, Activity Record of the Occupational Questionnaire, and an interview that included a work history) were administered by an occupational therapist. Results of these assessments were used to inform group co-leaders (one social worker and one occupational therapist per group) of their members' symptoms, coping mechanisms, attitudes towards work, rehabilitation readiness, life roles and values, and use of time in order to plan appropriate group intervention. Groups met for once-a-week 90 minute sessions. Group leaders used restructuring and systematic prolonged exposure to encourage group members to describe their traumatic experiences in order to neutralize negative affect states, mange symptoms, and work through guilt and distorted perceptions. Members attended until they began gainful employment. Descriptive data revealed that during the first year of the program, 9/11/2001-9/11/2002, 262 of the 3,567 clients seen (13.6%) returned to the work force.
A qualitative evaluation of 11 VDT users, who participated in a training program for the prevention of musculoskeletal and visual problems, investigated the extent of the application of the taught principles in everyday work. Data were collected over a 2 to 3 day period for each trainee, through an ergonomic work analysis in situ and semi-structured interviews, followed by recommendations, when appropriate, corresponding to the taught principles. A case analysis and a cross analysis of the data provided information about the developed ability for self-analysis of work regarding posture and visual comfort and what influenced it. A model depicting the process of transfer of knowledge and skills, from the training program to preventive action, was abstracted from data analysis. This model allows both the identification of problems in applying taught principles and the means to readjust the training program.
Interest in emergency evacuation planning has increased since the September 11 terrorist attacks (9/11). In turn, the Job Accommodation Network (JAN) started receiving more questions about how to include employees with disabilities in such plans. JAN case data on the emergency evacuation of people with disabilities were reviewed. Case data from the four years prior to 9/11 (from September 11, 1997, to September 11, 2001) were compared to case data from the four years after 9/11 (from September 11, 2001, to September 11, 2005).
College students, with or without disabilities, are faced with numerous stressful situations within the university environment. For an individual diagnosed with Asperger syndrome, success at this level requires non-traditional supports. With limited knowledge of this disorder, the university staff are faced with a distinct disadvantage in their efforts to outline an appropriate plan. While providing traditional academic assistance is now commonplace, federal laws mandate that universities widen the scope of support so as not to exclude any student from campus activities or programs. In an effort to provide a framework for support, this article interfaces diagnostic information with the realities of college life. Areas of focus include the transition process, social rules, engagement in academic activities, and mastering a new life of independence. It is hoped that the presented suggestions might prove helpful as universities begin to establish service support teams and outline plans of support.
Men under 25 years are at high risk of back injuries caused by manual handling. Self reports and functional capacity evaluations are commonly used to determine a worker's lifting capacity, however, amongst uninjured individuals, conflicting views exist regarding how perceived physical functioning matches actual functioning in the absence of fear of pain and/or re-injury. The aim of this study was to compare self-reports and actual lifting performance in a group of healthy young men aged 18-25 years. METHOD/PARTICIPANTS: A correlational prospective design compared perceived lifting capacity, using self-report and the Spinal Function Sort, and actual lifting capacity, using the EPIC Lift Capacity test in 31 subjects.
Subjects' self-reported lifting capacity varied more widely than their actual scores, indicating that they were less accurate at predicting their lifting performance using the self-report measure. One third of subjects were able to accurately self-report their lifting performance, approximately one-third underestimated, and the remaining third overestimated their lifting ability. Only two significant relationships were identified between self-reported and actual lifting performance for frequent knuckle-shoulder and floor-shoulder lifts. These correlations were weak and well below the 0.75 level considered necessary to be clinically significant.
This study found that self-report measures are not suitable when used in isolation. It is therefore recommended that self-report measures are used in conjunction with functional capacity evaluations to determine lifting capacity.
Students are faced with work demands requiring protracted and intense computer use. College students report using a computer seven days a week and cumulative hourly use per day can exceed that of adult workers. Extended daily computer use has been associated with an increase in the reporting of musculoskeletal symptoms for college-aged students. Manual control with a computer mouse dominates much computer use and mouse use has been associated with musculoskeletal complaints. New mouse designs offer alternative movement and postural strategies to potentially mitigate musculoskeletal stress. This study investigates the use of five computer mouse designs by college-aged students (18-25) as a part of a larger study which includes persons older than 25. Results for human performance, distal upper extremity posture (hand/wrist), and subjective data such as overall preference, ease of use, perceived control, and comfort are given for this population. Wrist extension is a risk factor for musculoskeletal injuries such as carpal tunnel syndrome. The current ergonomic standard calls for wrist extension to be below 30 degrees. Wrist extension exceeded 30 degrees for over 50% of the total movement time for 3 out of 5 mouse designs. Postural variations in hand molding of the metacarpophalangeal arch (MCP angle) across mouse design was shown to be related to mouse control and ease of use. Subjective evaluations showed no gender effect and overall preference was correlated to subjective evaluations of comfort, ease of use, perceived control, and, to a lesser extent, product attractiveness.
Data from the Total Army Injury and Health Outcomes Database (TAIHOD) were used to describe 28,352 fall-related hospitalizations among active-duty Army soldiers between 1980 and 1998. Soldiers who were younger than age 26, single, and had a high school education or less were at greatest risk. Falls from a height were more likely to be fatal than other types of falls, accounting for 88% of all fatalities. In cases where duty status was known, 64% of the falls took place while the soldier was on duty and half of these occurred during training. The most common type of fall during training was fall from a height (37%). Falls on stairs and ladders accounted for 49% of all off-duty falls. Future research should include identification of specific behavioral and occupational risk factors for falls, particularly those occurring during training activities, and falls occurring off duty.
Regional differences in Sweden in the prevalence of disability pension with a psychiatric diagnosis are unexplained, in spite of the significant impact on the population's health, rehabilitation systems, and the health care system. The purpose of this study was to describe the pattern of disability pensions with a psychiatric diagnosis and to analyze the impact of age and gender. We examined the incidence rates in one urban and one semi-rural region and compared these to national rates. The study sample was drawn from employed persons between 16-64 years of age who, because of their sickness insurance coverage, would be eligible to access disability pensions should it be necessary. Analysis of annual incidences and standardized morbidity ratios were made for 1980, 1985, 1990, 1995, and 1998. Data on disability pension cases were collected from the National Social Insurance registers. In the urban region we found that the proportion of men and women clearly outnumbered the national average: approximately twice the number of persons between 16-64 years of age with a psychiatric diagnosis were receiving a disability pension. In the semi-rural region there were fewer men overall on disability pensions with psychiatric disorders, but in 1980, 1985, and 1995 women clearly outnumbered men. Access to psychiatric care, unemployment, alcohol dependence, and previous sickness absence are suggested as possible factors that might affect the rates of disability pension in different geographical settings.
Residents of the county of Ostergötland, Sweden, who were 16-64 years of age in December 1984 and not pensioned (n=229,864), were followed in a prospective, cohort, study of data collected between 1985 and 1996. Using survival methods as the method of analysis, the likelihood of being granted a disability pension was 14% for women, 11% for men, and increased with age. Women less than 54 years of age were at higher risk than men (P<0.001), 69% of disability pensions granted were full-time and 31% were part-time, more women received part-time pensions (P<0.001). Whether the differences observed are due to gender bias in social insurance practices, to disease patterns, to occupational and work-related factors, or to a cohort effect has yet to be determined.
This study examines the distribution of psychological distress in twelve occupational groups over the decade 1987-1998 in the Quebec workforce. Cross-sectional data from the three phases of the Quebec Health and Social Survey are used with n = 9,450 in 1987, n = 10,947 in 1992 and n = 10,960 in 1998, totalling 31,357 workers aged 15 and over. Occupations are classified according to the Canadian Socio-economic Classification of Occupations. Prevalence estimates for occupational groups are computed and logistic regression analyses are conducted controlling for gender, age and marital status. The results show that the prevalence of workers with psychological distress increased sharply between 1987 and 1992 and declined back in 1998 but still increased compared to 1987. However, only non-qualified white collars, semi-qualified blue collars and male non-qualified blue collars show a significant increment in psychological distress over time. Analysis of the differentials in the prevalence of psychological distress gives greater odds of distress for supervisors, semi-qualified white and blue collar workers compared to upper managers. The odds for occupations are stable over time, gender, age and marital status. The odds of female workers significantly decreased in the three phases. It appears that the restructuring of the work environment and the perturbations in the larger society promoted an increase of psychological distress within definite segments of the workforce. The specific contribution of occupation is limited but supervisors and occupations requiring lower qualifications are more at risk regarding mental health at work.
We describe medical care received through workers' compensation (WC) and union-provided insurance surrounding work-related back injuries and examine relationships between care provided and time off work among a large cohort of carpenters.
Union records identified a cohort of 20,642 carpenters working in Washington State from 1989-2003 and their private health insurance claims. These data were linked to workers' compensation files from this state-run program including records of medical care.
Over 74,000 WC medical encounters resulted from 2959 work-related back injuries. Eleven percent received private care for musculoskeletal back pain within 90 days of work-related injury; this proportion increased with increasing lost days. Delay to physical therapy was more prevalent among those out of work longest. The proportion of claimants with care from both systems and from private utilization only increased after the first 90 days and, for the subset with at least one paid lost work day, after return to work.
Examination of medical care through both systems versus solely in workers' compensation provides a more complete understanding of back injury care while also demonstrating complexity. Differences in outcomes based upon treatment shortly after injury are worthy of further exploration.
The support of good management is fundamental to the success of any safety and health program. Residential construction is a high-risk industry requiring significant commitment by management to impact day-to-day safety and health challenges. Investigators have evaluated management practices and spending trends in a cohort of 228 residential homebuilders in the Denver metro area of Colorado. Findings suggest that companies significantly increased dollars allocated to support safety and health practices between 1991 and 1999. In addition, the HomeSafe Pilot Program has positively impacted financial commitments of partner companies. Resource allocations were significantly greater for specific expense categories when comparing pre to post HomeSafe intervention. This paper presents data on the use of written safety and health programs, safety committees, and workers compensation premium cost containment certification, as well as allocations to safety incentive programs (SIP), personal protective equipment (PPE), other safety equipment (OSE), and safety training (ST).
Approximately 25% of working-aged Americans with disabilities work full or part time, yet still face discrimination despite the passing of the American's with Disabilities Act (ADA) over 20 years ago.
To determine if the proportion of allegations of ADA Title I workplace discrimination with merit closed at any year between 1993 and 2008 differs among Whites, African Americans, Hispanics, and Asians; to determine if there was a change over time from 1993 to 2008 in merit closure rate within each race/ethnicity group; and to determine whether changes over time between 1993 and 2008 in the merit closure rate differ among the race/ethnicity groups.
Logistic regression was used for this cross-sectional panel study to model the merit closure rate for each ethnic group from 1993 to 2008 using 318,587 charging parties from the EEOC database.
All ethnic groups exhibited significant changes over time in the merit closure rate. There were significant differences in the closure rates among the race/ethnicity groups specifically at closure years 1995-2000, 2002, 2003, and 2006. Finally, there was evidence that the trends in merit closure rates over time differed significantly among the race/ethnicity groups.
There was significant evidence that the proportion of claims closed with merit was significantly different among the racial/ethnicity groups.
Among working aged adults (18-64) with disabilities, three out of 10 (32%) work full or part-time, compared to eight out of 10 (81%) of those without disabilities . In addition, 24.7% of women with a severe disability and 27.8% of men with a severe disability are employed, while women with a non-severe disability have an employment rate of 68.4% and men with a non-severe disability have an employment rate of 85.1% . This study examined data from the Behavioral Risk Factor Surveillance Survey from 1995-2002 to determine whether or not disparities exist in the rate of unemployment for women with disabilities, compared to men with disabilities and women and men without disabilities. In addition, regression analysis looked at the how disability and gender predict the outcome of unemployment. Results showed that there has been essentially no change with regard to employment for any of these populations. In addition, disability and gender were found to be the strongest predictors of unemployment for women with disabilities. Possible explanations were discussed as to the reasons for the results and issues were presented for future research.
This study reports trends in the pattern of injuries related to workplace violence over the period 1997-2007. It tracks occupations and industries at elevated risk of workplace violence with a special focus on the persistently high claims rates among healthcare and social assistance workers.
Industry and occupational incidence rates were calculated using workers' compensation and employment security data from Washington State.
Violence-related claims rates among certain Healthcare and Social Assistance industries remained particularly high. Incidents where workers were injured by clients or patients predominated. By contrast, claims rates in retail trade have fallen substantially.
Progress to reduce violence has been made in most of the highest hazard industries within the Healthcare and Social Assistance sector with the notable exception of psychiatric hospitals and facilities caring for the developmentally disabled. State legislation requiring healthcare workplaces to address hazards for workplace violence has had mixed results. Insufficient staffing, inadequate violence prevention training and sporadic management attention are seen as the key barriers to violence prevention in healthcare/social assistance workplaces.
By adapting to the changing health care environment, legislative reforms, and consumer needs, work rehabilitation programs have experienced a metamorphosis. This study surveyed occupational therapists currently employed in work programs to ascertain a current demographic profile of work rehabilitation programs. Respondents indicated the delivery of services in the areas of prevention, assessment and rehabilitation. The majority of work rehabilitation programs in this study provide services in the form of ergonomics, education and training, and job analyses at the worksite. The area of work injury prevention services is forecasted for increased growth among work rehabilitation programs.
In order to identify the relevant challenges in occupational health in the next century, changes in demographic profile and work activity must first be considered. Only then can the challenges be identified, and appropriate strategies be formulated to respond to these challenges. In a newly industrializing country such as Singapore, improved work conditions; the advent of new technology; a redistribution of work activity (with a reduction of factory workers and an increase in service sector workers); and an ageing workforce can be expected. These changes, together with a possible increase of some types of work related disorders (such as cumulative trauma disorders, and disorders resulting from psychosocial hazards); will determine the relevant occupational health challenges to be faced. Added to this would be society's higher expectations for health care, a humane and compassionate health care, and an improved quality of life. As a result, what is needed in Singapore might be (1) a shift in the focus of current health care activities to pay sufficient attention to new hazards at work, and newly emerging work related diseases, (2) improved training and development of health professionals to better prepare them to face these changes, and (3) a responsive and appropriate legislation to protect the health of all workers.
To examine employee's perception of safety and related workplace safety and prevention issues, including their use of self-protection measures and victimization experience.
The Workplace Risk Supplement (WRS) to the National Crime Victimization Survey (NCVS) was administered to 55,158 employed respondents who were 16 years or older.
Trained U.S. Census Bureau interviewers administered the WRS in all households selected for the NCVS during the 6-month reference period from January through June 2002. Responses from the 55,158 WRS respondents were weighted to obtain national estimates, resulting in 142,410,858 cases.
The demographic distribution of WRS respondents is very similar to that of the U.S. labor force. Seven percent of respondents reported that they worried about someone in their workplace attacking them, while nearly 4% experienced victimization. The majority indicated that they felt that their workplace, the neighborhood around their workplace, and places they traveled to as part of their job were either "Very Safe" or "Somewhat Safe" from crime. Six percent carried some type of self protection while at work although this varied by occupation.
Employees largely feel safe from violence while working. Differences in victimization by occupation bolster efforts to focus workplace violence prevention in high-risk occupations.
While back pain is common among health care workers in the United States, the epidemiology of back pain is unclear.
The purpose of this study was to estimate the incidence and trend of back pain from work-related injuries among health care workers.
Data from the Pennsylvania Work Injuries and Illnesses Reports from 2002 to 2006 were analyzed.
Estimated back injuries account for 24.6% of all reported injuries in healthcare workers in Pennsylvania. From 2002 to 2006, there was a 22.5% increase in the incidence of reported back pain in this population.
Due to a lack of detailed reports regarding the incidence of back pain among Pennsylvania healthcare workers, it is recommended that a survey of healthcare workers who perform patient handling be completed.
Contribute to the prevention of workplace violence by providing information about the nature and circumstances of nonfatal assaults among U.S. workers.
Data were collected from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work), a stratified probability sample of U.S. hospitals. Workplace violence victims identified from NEISS-Work voluntarily completed a followback interview detailing the nature and circumstances surrounding their workplace violence incident.
The majority of workplace violence injuries treated in emergency departments resulted from simple assaults that did not involve any lost time from work. Almost two-thirds of these workplace violence victims filed only an internal report. Eighty percent of the victims returned to their same jobs and will not change the way they do their jobs as a result of the violent incident.
Nonfatal workplace violence is an important risk for U.S. workers, particularly in some occupations and industries. Prevention strategies need to be tailored by occupation and work environment. Results from the healthcare section of this survey indicate high numbers of incidents during times when the healthcare workers were assisting patients with medical and non-medical needs.
In 2011, about 1.8 million or 8 percent of the 22.2 million veterans were women in the US. The unemployment rate for female veterans of the wars in Iraq and Afghanistan rose to 13.5%, above the 8.4% for non-veteran adult women.
To examine data from the Behavioral Risk Factor Surveillance System (BRFSS), from 2004-2011 to determine the relationship between employment and veteran status, disability and gender.
Chi square analysis was used to determine if significant differences existed between the employment rate of female veterans with disabilities and female veterans without disabilities, female non-veterans with disabilities and male veterans with disabilities. Binomial logistic regression analysis was used to determine how veteran status, disability and gender affected the likelihood of not being employed.
Significant differences were found in employment rate between female veterans with disabilities and female veterans without disabilities, but not when compared to female non-veterans with disabilities or male veterans with disabilities. Disability was the strongest factor increasing the likelihood of not being employed, though veteran status and female gender were also predictive.
Female veterans with disabilities experience low levels of employment. Policies and programs are needed to address the unique needs of these veterans.
Veterans with disabilities, especially those with posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) have difficulty obtaining and maintaining competitive employment.OBJECTIVE: To determine if there are significant differences in employment between veterans with and without disability, between veterans with a disability and nonveterans with a disability, and to investigate the association of veteran status and disability with employment.
Chi square analyses were conducted on data obtained from the 2010 Medical Expenditure Panel Survey to determine if significant differences in employment occurred between veterans with disabilities, veterans without disabilities and nonveterans with disabilities. Multivariate regression analyses were used to determine how veteran status and disability are associated with employment.RESULTS: Significant differences in employment were found between veterans with and without a disability; however, no significant differences existed in employment between veterans and nonveterans with a disability. Multivariate analysis showed that veteran status (aOR=1.80), having any disability (aOR=7.29), social disability (aOR=3.47) or a cognitive disability (aOR=3.16) were associated with not being employed.CONCLUSIONS: Veterans with disabilities are more likely not to be employed than veteran populations without disabilities. Veterans; however have unique disabilities, different than nonveterans with disabilities, that need to be addressed, such as social and cognitive disabilities resulting from TBI and PTSD. Future research should focus on evaluating the effectiveness of employment programs and policies designed to address the unique issues faced by veterans with disabilities.
This paper was based on case study research at the Swedish Mail Service Division and it addresses learning time to sort mail at new districts and means to support the learning process on an individual as well as organizational level.
The study population consisted of 46 postmen and one team leader in the Swedish Mail Service Division.
Data were collected through measurements of time for mail sorting, interviews and a focus group.
The study showed that learning to sort mail was a much more complex process and took more time than expected by management. Means to support the learning process included clarification of the relationship between sorting and the topology of the district, a good work environment, increased support from colleagues and management, and a thorough introduction for new postmen.
The identified means to support the learning process require an integration of human, technological and organizational aspects. The study further showed that increased operations flexibility cannot be reinforced without a systems perspective and thorough knowledge about real work activities and that ergonomists can aid businesses to acquire this knowledge.
Theories and traditions emphasizing the centrality of caring have guided the evolution of the healthcare professions. In contemporary practice, creating a therapeutic context in which healing can occur relies not just on the caring dispositions of individual clinicians, but also on the collective relational capacities of interprofessional healthcare teams. This article describes the intersection and complementarity of relational and interprofessional learning approaches to health education, provides exemplars of shared learning models and discusses the benefits and obstacles to integrating relational and interprofessional philosophies into real world practice.
The purpose of this article is to share the details, outcomes and deliverables from an international workshop on work transitions in London, Ontario, Canada.
Researchers, graduate students, and community group members met to identity ways to advance the knowledge base of strategies to enhance work participation for those in the most disadvantaged groups within society.
A participatory approach was used in this workshop with presentations by researchers and graduate students. This approach included dialogue and discussion with community members. In addition, small group dialogue and debate, world cafe discussions, written summaries of group discussion and reflection boards were used to bring new ideas to the discussion and to build upon what we know.
Two research imperatives and six research recommendations were identified to advance global dialogue on work transitions and to advance the knowledge base. Occupational justice can be used to support future research directions in the study of work transitions.
Moving forward requires a commitment of community of researchers, clinicians and stakeholders to address work disparities and implement solutions to promote participation in work.
The article examines the current status and future directions of assessment and planning in vocational rehabilitation (VR). Major themes include (a) the increasing emphasis on consumer involvement, (b) career development as the ultimate goal of the VR process, (c) integrative assessment of the 'whole' person, (d) employers as partners in planning and service delivery, and (e) the expanding role of rehabilitation counselors in a highly diversified professional marketplace.
Health profession education programs often struggle with barriers to implementing interprofesssional educational (IPE) initiatives, limiting early and consistent exposure of students to core IPE competencies. Few published reports are available to guide the implementation of IPE programs into practice. This article describes a successful and evolving partnership between an independent university and a tertiary care hospital. The IPE goals of this partnership were to expose students to roles of other disciplines in the complex hospital environment and integrate acute care exposure throughout the Doctor of Physical Therapy and Master of Science in Occupational Therapy curricula.
Faculty and students, patients and families, and occupational and physical therapy clinicians participated in a series of learning activities in an acute care setting involving interprofessional teams of students. Activities included observations of OT and PT clinicians providing standard patient care, practice conducting team patient interviews, and interactive treatment planning sessions conducted live via videoconferencing technology between a patient's hospital room and an academic classroom on the university campus. The activities generally were designed to improve student preparedness for working as part of an interprofessional team in an acute care setting.
Student and clinician feedback support the early development of student IPE competencies, including the appreciation and understanding of professional roles in the team approach to patient care and the development of effective communication skills. The partnership between the academic institution and tertiary care hospital is an effective vehicle to deliver and sustain IPE educational initiatives in the acute care setting. Current and planned IPE curriculum integration are discussed along with a preliminary analysis of IPE outcomes.
The public vocational rehabilitation (VR) system in the United States faces many challenges in the 21st century. To prevail amid such challenges, rehabilitation professionals will need to embrace several specific skills (anticipating change, engaging in more generative than adaptive learning to make rehabilitation organizations true "learning organizations" and adoption of a comprehensive ecological framework for planning VR system change). As a preface to understanding these skills, this paper discusses the current developmental stage of the public VR system, followed by lessons learned in its first century of existence, as well as some logical propositions about the future of VR.
The 'accessible' job market of the 1990's has given way to a challenging job market in a climate of economic uncertainty in the early Twenty-First Century. For vocational rehabilitation professionals this change requires the strategic use of workplace supports to increase the value and sustainability of work performed by people with disabilities in competitive jobs. An analytical framework for leveraging the natural supports of the workplace is provided by the workplace ecology as a bounded environment in which relationships between workers and supervisors promote learning and enhanced performance. The dynamics of the workplace ecology are explored with particular reference to workers with disabilities receiving supported employment services. Recommendations are made for leveraging the workplace ecology to the benefit of the supported worker. Implications for supported employment services in the new millennium are discussed.
This article presents a rights-based approach to the way occupational health and safety is understood, departing from medical, engineering, and technocratic approaches that dominated the field throughout the 20th century. Moving toward a 21st century concept of the good society - based on citizenship rights and principles of universalism - a social protection-based system of assessing governments' performance in protecting workers' health and well-being is proffered.
A Work Security Index (WSI) is used as a benchmarking system for evaluating national or local level governments' performance in this domain. Data from 95 countries in all regions of the world were used. A pioneering tool the WSI grouped and ranked countries based on governments' protection of workers' health and safety.
Data represent findings from 95 national governments, as well as workers and employers.
Among 95 countries, most have much work to do to provide the minimum measures to protect their working populations. Results reveal that women workers face particular social and economic insecurities and inequalities.
We attempt to inform a broad audience about the WSI, how it can be used at multiple levels in any country for the protection of workers' health, safety, and well-being, and the need to do so.
Work injury rehabilitation is a new concept in Mainland China. In 2001, the first work injury rehabilitation centre was established in Guangzhou under the management of the Guanghzhou Bureau of Labour and Security. This paper reviews the profile of a cohort of workers with injuries who received rehabilitation services at this centre. The changes in the physical capacity, daily function, and quality of life of the workers with injuries before and after the treatment services were also reviewed. A total of 380 were extracted from the database which occupied 79% of the total patient population admitted to the centre between 2003 to 2004. The assessment results suggested that workers with injuries showed increases in physical capacity in terms of the range of motion, muscle strength and walking tolerance. The daily functioning by using Barthel Index was also improved. Quality of life assessed with the WHOQOL also demonstrated an increase in the physical and psychological domains. Work injury rehabilitation in Guangzhou is at its infancy stage. The cooperation between the rehabilitation centre, employers and workers is of the utmost importance for a successful return to work outcome. The workers' compensation and rehabilitation policy also dictates the future of success of the rehabilitation services.
A questionnaire composed of 55 items that addressed activities of daily living (ADL) abilities and 13 basic vocational competencies, such as memory and muscular power, was completed by 48 nondisabled male workers aged ≥45 years. The workers were all engaged in the manufacturing industry. All respondents found the following five tasks easy to do: wring a towel, put arms through sleeves, open and shut a door, turn a tap on and off, and open and shut a sliding door. Among basic vocational competencies, the highest performance, with but a small standard deviation, occurred with the muscular power competency; a low performance with a large standard deviation (P=0.05) occurred with concentration. No age difference was discerned in planning ability, cooperativeness, muscular power, staying power, manual adeptness, and sense of equilibrium, whereas in learning ability, agility, and concentration, people aged ≥65 years showed significantly lower performance (P=0.05). The characteristics of vocational competencies in manufacturing industry workers aged ≥45 years were fond to be linked to ADL abilities, and the effectiveness of the ADL abilities survey, prepared on an experimental basis, was confirmed for the evaluation of vocational competencies.
To describe the epidemiology and re-employment outcomes of employees with industrial injuries and provide further information for the prevention of industrial injuries and work rehabilitation with the purpose of lower injury rate and cost savings.
Learn about epidemiology and re-employment status by investigating 467 employees separately when in hospital and half a year after leaving hospital. The investigation form is designed according to the Classification Criterion of Employee's Casualty Accident (UDC658.382 GB6441-86) and local industrial injury status.
Employees with industrial injuries have obvious regional characteristics in aspects such as sex composition, age, position of injury, injury causes, injury type, and vocation before suffering injury, level of education, degree of disability, employment wishes, and actual employment status.
Industrial injury presents obvious characteristics in epidemiology. Therefore, it should take respective characteristics into consideration when conducting prevention of industrial injury and work rehabilitation.
The purpose of this project was to continue the development of the Work boxTM following three studies to standardize instructions and determine test-retest reliability. Normative data were collected from 118 non-disabled female subjects between the ages of 20 and 49 years. Means, standard deviations, and ranges of performance for 5-year-age intervals were calculated and reported for assembly time, disassembly time, and total test time. Analysis of the data indicates a minor, though not significant, decline in test performance with increasing age and great variability in completion times overall.
This study aimed to evaluate the criterion validity and the diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) regarding the identification of depressive and anxiety disorders in an insurance medicine setting.
Our sample consisted of 230 individuals who applied for a work disability benefit due to mental health problems.
Depressive and anxiety disorders were assessed using the 4DSQ and the Composite International Diagnostic Interview (CIDI). Internal consistency was determined by calculating Cronbach's alpha values. Criterion validity was evaluated by regression techniques. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate diagnostic accuracy.
Of the 230 participants 109 (47.4%) had a current DSM-IV depressive disorder and 146 (63.5%) an anxiety disorder. The 4DSQ scales showed an excellent internal consistency. The depression scale of the 4DSQ had specific sensitivity for major depressive disorder. The anxiety scale was also sensitive for the anxiety disorders. The area under the ROC curve (AUC) indicated good diagnostic accuracy of the 4DSQ for assessing depressive and/or anxiety disorders: AUC-value 0.81 for both depression and anxiety.
Although the 4DSQ shows good criterion validity and diagnostic accuracy with respect to depressive and anxiety disorders in applicants for a work disability benefit due to mental health problems, the feasibility of the 4DSQ as a screening measure for depressive and anxiety disorders is limited due to the high prevalence of depressive and anxiety disorders.