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Toward improved measurement of cognitive and behavioural work demands
Abstract
Determination of the cognitive and behavioural demands of work is an important part of holistic workplace intervention. Attention to these factors is especially important when developing return-to-work programs for persons with reduced cognitive, behavioural or psycho-emotional capacity, and when designing risk management programs in organizations. Occupational therapists have the background knowledge and skills to assess these components of work, but often lack valid and reliable measurement tools. This paper reports on three field studies that assessed the reliability and validity of ratings made by novice users of the City of Toronto Job Demands Analysis, which includes a measure of cognitive and behavioural work demands. Numerous challenges to accuracy and reliability that are common to empirical measurement were disclosed, including the necessity for clear and strong definitions, and the importance of thorough rater training. Implications for therapist training and mentorship are discussed.
... Tertiary interventions treat those with mental illnesses and include building the capacity of workers to cope with workplace stressors, advocating with employers for workplace accommodations, and supporting returning workers . Occupational therapists have expertise in cognitive behavioural job demands analysis; this can facilitate return-to-work planning through a process of matching the abilities of the worker to the demands of the job (Lysaght, Shaw, Almas, Jogia, & Larmour-Trode, 2008). Another specific occupational therapy approach is cognitive work hardening, which uses progressively more difficult tasks to develop occupational performance skills, focusing on stress management, coping skills, interpersonal conflict resolution, and functional skills directly related to work (Wisenthal & Krupa, 2013;Wisenthal, Krupa, Kirsh, & Lysaght, 2018). ...
... Instead, it might be useful to document and define a list of evidence-based services that an occupational therapist could provide. For example, it might be useful to document occupational therapy expertise in providing functional cognitive-behavioral assessments and interventions (Lysaght et al., 2008;Marfeo et al., 2017), cognitive work hardening (Wisenthal et al., 2018;Wisenthal & Krupa, 2013), supported employment (Marshall et al., 2014), and guidance regarding accommodations (Dewa et al., 2016), as these evidence-based approaches are congruent with the unique occupational perspective. Other services, such as health promotion, case management, and training, may also be relevant and important (Joyce et al., 2016) but are not as specific to occupational therapy expertise. ...
... Therapists newer to their WMH positions were more likely to indicate that limited training was a barrier to their practice and gave higher ratings of importance to many of the identified topic areas, relative to more experienced therapists. This finding is consistent with a report by Lysaght et al. (2008) that many new therapists are directly entering private practice in workplace health; however, they require additional training to prepare for this type of skilled work. Mentorship was identified as a strategy that could be very helpful for novice therapists as they learn to negotiate more complex issues related to clients, their job, and the workplace. ...
Background.:
Workplace mental health (WMH) is an important and expanding practice area for occupational therapists.
Purpose.:
This cross-sectional study explores the current practices and support needs of Ontario-based occupational therapists in WMH.
Method.:
Registrants from the provincial association who provide mental health and/or work-related services were invited to participate. Ninety-three therapists completed an online survey; 10 participated in follow-up focus groups. Analysis involved descriptive statistics of the survey data and content analysis of the focus group data.
Findings.:
Return to work, reactivation, and functional cognitive assessment were the most commonly reported services. Key challenges were limited funding and training and lack of awareness of the occupational therapy role. Therapists emphasized the importance of raising the competence, credibility, and profile of occupational therapy in WMH.
Implications.:
Defining the role of occupational therapy, developing training and resources, and advocacy are needed to advance occupational therapy practice within this rapidly changing field.
... They can also vary over time in accordance with societal and technical developments. During the agrarian and industrialisation eras, work required primarily human musculoskeletal efforts [18]. The development of technology has to a large extent reduced biomechanical demands and made production more effective, but it has also created new demands. ...
... New and developed technology in production means new ways of performing work duties and organising production. Advanced technology together with new industry branches, like knowledge and service branches, make increased demands on employees' cognitive abilities [18]. ...
... Being expected to work independently yet still keep to the rules and be able to overview production steps, makes high demands on an individual's cognitive abilities. In modern working life, these expectations are common [18,53]. There are expectations on the employee to manage their work independently, take responsibility, prioritise, make decisions and deliver a qualitatively good result in the leanest way [54]. ...
Background:
Since work ability is manifested in working life and ``bought'' by employers, employers perceptions of the concept are important to understand. Studies have shown that people with health problems want to take part in the labour market, but experience difficulties in gaining access. Additionally, studies have demonstrated the doubt felt by employers when they consider hiring a person with a disability.
Objective:
The aim was to identify and characterise employers' conceptions of work ability.
Methods:
The study design was qualitative with a phenomenographic approach. Six male and six female employers from various workplaces and geographical areas in Sweden were interviewed.
Results:
Three domains were identified: employees' contributions to work ability, employers' contributions to work ability and circumstances with limited work ability. Work ability was regarded as a tool in production and its output, production, was the main issue. The employees' commitment and interest could bridge other shortcomings.
Conclusions:
The employers highlighted their own contributions in shaping work ability in order to fit with work circumstances. Health problems were not the only limiting issues; other circumstances, such as individual characteristics and contextual factors, could limit work ability too. Knowing the importance of commitment and interest is valuable in work rehabilitation.
... In working life today, self-management is supposed to be part of the ability to work [34]. Modern working life is also characterised by extended cognitive work duties [45]. Self-management puts demand on cognitive abilities and coping skills, such as planning, organising and prioritising, as well as selfconfidence [27,34]. ...
Background:
Mental health problems (MHP) are common in working life and can be hard to respond to for employers. Therefore, knowledge of employers' perceptions of employees with MHP is important to support coping efforts of persons and their work environments.
Objective:
Identify and characterise employers' perceptions of the impact of MHP on work ability.
Methods:
Twelve employers with experience of employees with MHP were interviewed. Data were analysed with a phenomenographic method.
Results:
The first main category, "Experiences of employees with MHP", included experiences of diffuse and unexpressed signs of the onset of MHP and frustration among employers and work-mates which was difficult to verbalise. MHP could also be turned off, thus having no impact on work ability. The second main category, "Strategies to handle effects of MHP in the workplace", included the importance of continual responsiveness and communication, and of fluctuating adaptations. The informants expressed diversity in the workplace as a strategy.
Conclusions:
Employers have experiences of, as well as strategies for, how to handle MHP at times when they impact with the ability to work. However, neither experiences nor strategies were explicitly pronounced and verbalised which makes it a challenge to develop strategies and guidelines in workplaces.
... The importance of cognitive and emotional/interpersonal job demands on employees have traditionally been underemphasized and underrepresented in the disability assessment field, despite the evolving importance of these work demands in the economy at large. In this regard, an article (Lysaght, et al. 2008) titled "Towards improved measurement of cognitive and behavioural work demands" and published in "Work: A Journal of Prevention, Assessment and Rehabilitation", notes that determination of the cognitive and behavioural demands of work is an important part of holistic workplace intervention. The article, written from an occupational therapy perspective, observes that these factors are especially important when developing return-to-work programs for persons with reduced cognitive, behavioural or psychoemotional capacity, and when designing risk management programs in organizations. ...
A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the
physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and there-fore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.
... In the workplace, existing cognitive and behavioural job demands analyses (e.g. utilized by the City of Toronto in Toronto, Ontario, Canada [10]) necessitate clear definitions and field-testing to ensure validity [11] but hold promise for standardizing the translation of workplace demands into the health domain (and vice versa). For both "safety sensitive" and "decision-critical" workers, the medical assessment must be relevant, valid, and reliable, comparing the worker's capabilities to the demands of the job. ...
"Safety-sensitive" workers, also termed "safety-critical" workers, have been subject to fitness to work assessments due to concerns that a performance error may result in worker injury, injury to coworkers or the general public, and/or disruption of equipment, production or the environment. However, there exists an additional category of "decision-critical" workers, distinct from "safety-sensitive" workers, in whom impairment may impact workplace performance, relationships, attendance, reliability and quality. Adverse consequences in these latter areas may not be immediately apparent, but a potential "orbit of harm" nevertheless exists. Workplace consequences arising from impairment in "decision-critical" workers differ from those in "safety-sensitive" personnel. Despite their importance in the occupational context, "decision-critical" workers have not previously been differentiated from other workers in the published literature, and we now outline an approach to fitness to work assessment in this group.
... This parallels research which has associated effective employment support interventions within recovery approaches [7,10,79,80]. Occupational analysis skills [81] were used to identify modifications to work tasks, schedules or performance approach, seen as crucial to job retention in Secker and Membrey's [44] qualitative study. Finally, group work, well established in mental health generally [82][83][84], used processes of peer support, empathy and education. ...
To understand experiences and perspectives of job retention project users in relation to challenges faced and support received; to develop explanatory insight into effective interventions.
14 employed users of a United Kingdom job retention project, with a range of mental health problems.
Semi-structured individual interviews which were collaboratively designed with service users. Data analysis involved deductive & inductive thematic analysis, constant comparative analysis, and service user collaboration.
Participants' feelings of guilt and self blame were a major obstacle to job retention. The project helped them address these by supporting a reappraisal of their situation. This assisted identification of job accommodations and adjustments and confidence in self advocacy. Thus an important basis for improved dialogue with their employer was established. A peer support group provided an important adjunct to individual project worker interventions. 10 participants retained employment; three of those who did not were helped to retain work aspirations.
The project effectively used a multi-faceted approach involving a person - environment-occupation focus on the worker, their work, and workplace. Such complex interventions may offer more promise than those interventions (such as cognitive behavioural therapy) which have a primary focus on the individual worker.
... The identification and suggested modifications to work tasks, schedules or performance approach, identified as crucial to job retention in Secker and Membrey's (2003) qualitative study, required occupational analysis skills (Lysaght, Shaw et al. 2008). Finally, group work, well established in mental health generally (Davidson, Chinman et al. 1999;Free 1999;Yalom 2005) used processes of peer support empathy and education for those who attended the support group. ...
Over the next few decades the number of cancer survivors in the workplace will escalate to unprecedented levels. The majority of cancer survivors typically do not experience major challenges in the area of work. However, there are those cancer survivors who find that persistent symptoms and functional changes post primary treatment for cancer, health care provider, individual, workplace and societal responses to workplace reintegration can influence those wanting to or needing to return to or remain in the workplace. This chapter provides an overview of the challenges faced by individuals in the aftermath of diagnosis and treatment of various types of cancer. Models of cancer and work are presented. Various interventions are discussed. At present, the literature on interventions is lacking in numbers and effectiveness. Intervention and cancer specific accommodation (e.g., reducing the impact of cognitive limitations of work) research represents a critical next step.
Work analysis is fundamental to designing effective human resource systems. The current investigation extends previous research by identifying the differential effects of common design decisions, purposes, and organizational contexts on the data generated by work analyses. The effects of 19 distinct factors that span choices of descriptor, collection method, rating scale, and data source, as well as project purpose and organizational features, are explored. Meta-analytic results cumulated from 205 articles indicate that many of these variables hold significant consequences for work analysis data. Factors pertaining to descriptor choice, collection method, rating scale, and the purpose for conducting the work analysis each showed strong associations with work analysis data. The source of the work analysis information and organizational context in which it was conducted displayed fewer relationships. Findings can be used to inform choices work analysts make about methodology and postcollection evaluations of work analysis information. (PsycINFO Database Record
(c) 2015 APA, all rights reserved).
Service systems are often characterized by large components of human work and the need to make decisions based on human performance. Human cognitive limitations and the abilities of computers to compensate led to decision support systems DSS. While a computerized DSS fits the needs of human cognitive limits, the strengths of human cognitive abilities are often overlooked. Human performance is often monitored by task completion in terms of timeliness and accuracy. A failure of this is that cognitive feedback is generally not given to the operator until after the task. Dashboard displays that are already widely used in manufacturing and other operational applications give current performance information and can take advantage of human cognitive capabilities. This paper presents the concept of decision support in human performance by exploring the extension of the dashboard display concept to human performance monitoring as a cognitive feedback mechanism. Examples specific to the service sector are provided in the context of a Help Desk environment.
Although it appears that many assume job analysis information is accurate, there is considerable evidence from other fields to suggest that the types of subjective judgments often involved in job analysis may be subject to systematic sources of inaccuracy. Drawing from the social, cognitive, and industrial-organizational psychology literatures, this review develops a framework that delineates 16 potential sources of inaccuracy in job analysis. This includes such social sources as social influence and self-presentation processes as well as cognitive sources such as limited and biased information processing. For each source of inaccuracy, the relevant literature is first reviewed, its potential operation in the job analysis context is described, and propositions for future research are derived. In addition, the likelihood of these sources of inaccuracy across various job analysis facets are described, concluding with recommendations for research and practice. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This paper presents a meta-analysis of published job analysis interrater reliability data in order to predict the expected levels of interrater reliability within specific combinations of moderators, such as rater source, experience of the rater, and type of job descriptive information. The overall mean interrater reliability of 91 reliability coefficients reported in the literature was .59. The results of experienced professionals (job analysts) showed the highest reliability coefficients (.76). The method of data collection (job contact versus job description) only affected the results of experienced job analysts. For this group higher interrater reliability coefficients were obtained for analyses based on job contact (.87) than for those based on job descriptions (.71). For other rater categories (e.g., students, organization members) neither the method of data collection nor training had a significant effect on the interrater reliability. Analyses based on scales with defined levels resulted in significantly higher interrater reliability coefficients than analyses based on scales with undefined levels. Behavior and job worth dimensions were rated more reliable (.62 and .60, respectively) than attributes and tasks (.49 and .29, respectively). Furthermore, the results indicated that if nonprofessional raters are used (e.g., incumbents or students), at least two to four raters are required to obtain a reliability coefficient of .80. These findings have implications for research and practice.
The value of research on the accuracy of job analysis is questioned. It is argued that the traditional criteria employed to evaluate job analysis accuracy (i.e., interrater agreement and deviations from proxy true scores) provide information of little practical value. Alternative criteria focusing on the consequences of job analysis data are suggested. Consequence-oriented criteria are clarified through a review of the various inferential leaps or decision points that job analysis supports. In addition, the consequences of job analysis are also thought to be a function of the rules governing the making of job-analysis-based inferences which, unfortunately, are sometimes unspecified in even the most molecular job analysis methodologies. Copyright © 2000 John Wiley & Sons, Ltd.
Psychosocial risk factors have been considered as characteristics of the work environment rather than an individual issue, but their presence in the workplace is usually measured by self-reported questionnaires, based on worker attitudes. The objective of the study was to compare a self-reported measure of psychological job demands in a bus driver sample with selected indicators of bus company activity, as external 'objective' indicators, in order to assess its external validity. The final sample included 713 drivers in 41 routes. Self-reported measures of psychosocial work risk factors were obtained by the Job Content Questionnaire (JCQ). Four external indicators were available for each route: passengers, break times, bus incidents, and regulating actions. Spearman's correlation coefficient was estimated to assess the validity. Correlation coefficients showed that self-reported psychological demands were statistically significant correlated (p<0.05) with two external indicators: bus incidents (rho=0.397), and regulating actions (rho=0.475). Self-reported psychosocial risk factors have been compared with independent external indicators of the psychosocial work environment, trying to avoid any subject's perception. According to our results, psychological demands measured by the JCQ seem to reflect the actual psychosocial work environment. Other studies are necessary to confirm these results and to assess job control and job social support. This would be another step in improving our knowledge of the quality of measurement of psychosocial risk factors.
Although the accuracy of job analysis information is critically important, standards for accuracy are not clear. Researchers have recently begun to address various aspects of job analysis accuracy by investigating such things as potential sources of inaccuracy in job analysis as well as attempting to reconceptualize our notions of job analysis accuracy. This article adds to the debate by first discussing how job analysis accuracy has been conceptualized. This points to difficulties in the prevalent ‘true score’ model upon which many of these discussions have been based. We suggest that discussions of job analysis accuracy would benefit from a consideration of the validity of job analysis inferences, as a complement to the more traditional focus on the validity of job analysis data. Toward this end, we develop a model of the inferences made in the job analysis process, outline some of the ways these inference could be tested, and discuss implications of this perspective. Copyright © 2000 John Wiley & Sons, Ltd.
We fundamentally disagree with Sanchez and Levine (this issue) on several issues. Terminologically, we are troubled by their failure to differentiate between the descriptive process of rating verifiable work characteristics (i.e., job analysis) versus the subjective process of inferring worker ability and ‘other’ (AO) requirements (i.e., job specification). Although ‘consequential validity’ is crucial for evaluating job specifications, it is largely irrelevant for assessing properly conducted job analyses. Ontologically, we reject their relativist view that an objective reality does not exist when describing work activities. When verifiable descriptors are rated using sound rating scales, independent judges can definitively assess position rating accuracy; such a review constitutes all the ‘validity’ evidence needed for the job analysis per se. We discuss a number of additional concerns, including the way in which practitioners deal with true cross-position ratings variability, and the role of holistic inferences. Copyright © 2000 John Wiley & Sons, Ltd.
Reports 3 errors in the original article by K. O. McGraw and S. P. Wong (Psychological Methods, 1996, 1[1], 30–46). On page 39, the intraclass correlation coefficient (ICC) and r values given in Table 6 should be changed to r = .714 for each data set, ICC(C,1) = .714 for each data set, and ICC(A,1) = .720, .620, and .485 for the data in Columns 1, 2, and 3 of the table, respectively. In Table 7 (p. 41), which is used to determine confidence intervals on population values of the ICC, the procedures for obtaining the confidence intervals on ICC(A,k) need to be amended slightly. Corrected formulas are given. On pages 44–46, references to Equations A3, A,4, and so forth in the Appendix should be to Sections A3, A4, and so forth. (The following abstract of this article originally appeared in record 1996-03170-003.). Although intraclass correlation coefficients (ICCs) are commonly used in behavioral measurement, psychometrics, and behavioral genetics, procedures available for forming inferences about ICC are not widely known. Following a review of the distinction between various forms of the ICC, this article presents procedures available for calculating confidence intervals and conducting tests on ICCs developed using data from one-way and two-way random and mixed-effect analysis of variance models. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Job analysis is used in a variety of fields to identify the nature of work performed. Occupational therapists use job analysis is a basis for evaluating injured workers, planning rehabilitative programs, structuring preemployment screening protocols, developing transitional work plans, and conducting environmental modification and risk management programs. There is little evidence in the literature of a theoretical basis or practical framework for job analysis in occupational therapy, although the theory that underlies occupational therapy provides a general foundation. Current job analysis methods appear inadequate for the wide range of practice applications and for responding to the changing nature investigation of methods derived from occupational therapy and other disciplines, development of documentation approaches suited to a variety of job types, and attention to validity and reliability o f results.
The variations in return to work outcomes for ill or injured persons experiencing health leaves are complex. However, it is important to comprehend these variations in order to develop evidenced-based practice in work rehabilitation. Currently, a plethora of studies exist in the literature that have attempted to explain the variations in work outcomes. A 20-year review of the literature on work outcomes has revealed several limitations in using this knowledge in occupational therapy. The study of return to work outcomes is, for the most part, atheoretical and the knowledge base is fragmented and disorganized. In addition, the literature does not reflect a consistent understanding of the multidimensional nature of either work disability or the facilitators for return to work. In this paper, the Occupational Competence Model is presented as a framework for filling this gap. This model is used here to organize and synthesize the factors previously studied on work outcomes to foster an understanding of this literature from an occupational therapy perspective and the future study of work outcomes and work rehabilitation.
Although working is considered by occupational therapy practitioners to be an important life role, there is very little information about the nature of working in the occupational therapy literature. This article reviews the construct of working in three ways: 1) The history of working and how it has shaped the modern beliefs about working; 2) The nature of working; and 3) The health promoting attributes of working. The paper will also discuss research done on how working is viewed by individuals with disabilities and will touch on some of the implications of the cultural bias in the workplace toward workers with disabilities. Through this increased knowledge of the nature of working, occupational therapy practitioners and other vocational rehabilitation professionals will be better equipped to break down the subtle cultural barriers, and help individuals with disabilities to participate in working.