A Model of Supervisor Decision-Making in the Accommodation of Workers with Low Back Pain

Examining information systems use to facilitate the workplace accommodation process

BACKGROUND

The workplace accommodation process is often affected by ineffective and inefficient communications and information exchanges among disabled employees and other stakeholders. Information systems (IS) can play a key role in facilitating a more effective and efficient accommodation process since IS has been shown to facilitate business processes and effect positive organizational changes.

OBJECTIVE

Since there is little to no research that exists on IS use to facilitate the workplace accommodation process, this paper, as a critical first step, examines how IS have been used in the accommodation process.

METHODS

Thirty-six interviews were conducted with disabled employees from various organizations. Open, axial, and selective coding were part of the analysis. Fuzzy set qualitative comparative analysis was used to identify different levels of IS use based on participants' descriptions.

RESULTS

An IS used in the workplace accommodation process consists of electronic request form, accommodation checklist, special budget, specific role, ancillary service, formal policy and procedure. There are different levels of IS use in the current accommodation process. The high-level IS use often results in a better accommodation performance than the low-level IS use, including high efficiency, high effectiveness, and low emotional tolls. Nevertheless, the high-level IS use often uses a specific, inflexible template as well as disregards human elements in the accommodation process.

CONCLUSION

This work provides implications that future IS design should raise awareness of disability and accommodation, account for individual differences, involve multiple stakeholder inputs, as well as address the fundamental social issues in the accommodation process.

Active engagement of managers in employee RTW and manager-employee relationship: managers' experiences of participating in a dialogue using the Demand and Ability Protocol

PURPOSE

To describe how managers of employees on sick-leave, due to chronic pain conditions, experience participating in a three-party meeting using the Demand and Ability Protocol (DAP) in the return-to-work process.

MATERIALS AND METHODS

This study is based on individual semi-structured interviews with 17 managers of employees with chronic pain. Interviews were conducted after participating in a three-party meeting including the employee, manager, and a representative from the rehabilitation team. The data were analyzed using thematic analysis with an inductive approach.

RESULTS

Two main themes were identified - "to converse with a clear structure and setup" and "to be involved in the employee's rehabilitation." The first theme describe experiences from the conversation, and the second theme reflected the managers' insights when being involved in the employee's rehabilitation. The themes comprise 11 sub-themes describing how the DAP conversation and the manager's involvement in the rehabilitation may influence the manager, the manager-employee relationship, and the organization.

CONCLUSIONS

This study show, from a manager's perspective, how having a dialogue with a clear structure and an active involvement in the employee's rehabilitation may be beneficial for the manager-employee relationship. Insights from participating in the DAP may also be beneficial for the organization.IMPLICATIONS FOR REHABILITATIONA structured dialogue between the employee, employer, and rehabilitation supports the return to work (RTW) processA structured dialogue and collaboration may strengthen the relationship between the manager and employeeAn active engagement of managers in the employeès RTW process is beneficial for the manager-employee relationship, and for the organisationHealthcare professionals should collaborate with the workplace to promote participation of managers.

Qualitative Assessment of Perceived Organizational Support for Employed Breast Cancer Survivors

OBJECTIVE

A more detailed understanding of unmet organizational support needs and workplace-based best practices for supporting cancer survivors is needed.

METHODS

Ninety-four working breast cancer survivors responded to an open-ended survey question regarding the desired types of organizational support that were and were not received during early survivorship. We performed content-analysis of qualitative data.

RESULTS

Major themes included instrumental support, emotional support, and time-based support. The need for flexible arrangements and reduced workloads was mostly met. Unmet needs included navigation/coordination, understanding/empathy, and time off for treatment and recovery.

CONCLUSIONS

Organizational support can help cancer survivors manage their health and work roles, diminishing work-health conflict and turnover intent. Study findings can be used to design targeted interventions to fulfill cancer survivors' unmet organizational support needs, which may also apply to workers with other chronic health conditions.

The Job Leeway Scale: Initial Evaluation of a Self-report Measure of Health-Related Flexibility and Latitude at Work

Purpose Evidence suggests that workers manage health-related challenges at work, in part, by using available leeway to perform work differently. The purpose of this study was to evaluate the reliability and validity of the Job Leeway Scale (JLS), a new 18-item self-report questionnaire designed to assess worker perceptions of available flexibility and latitude to manage health-related challenges at work. Methods Workers seeking assistance for workplace difficulties due to chronic medical conditions (n = 119, 83% female, median age = 49) completed the JLS along with other workplace and health measures. Construct validity was assessed using exploratory factor analysis (EFA), and concurrent validity was assessed by associations with related measures. Results Mean item scores ranged from 2.13 to 4.16 within a possible range of 0-6. The EFA supported three underlying factors: organizational leeway (9 items), task leeway (6 items), and staffing leeway (3 items). Internal consistency (alpha) ranged from 0.78 to 0.91 for subscale scores and 0.94 for the total score. The JLS showed moderate correlations with other work outcome measures including work fatigue, self-efficacy, engagement, and productivity. Conclusion The JLS is a promising new measure with initial support for its reliability and validity to assess worker beliefs of available flexibility to manage health symptoms at work, and this construct may have organizational implications for worker support and accommodation.

Examining the impact of reasonable accommodation appraisals on New Zealand managers' attitudes toward hiring people with disability

Purpose

Managers are responsible for implementing reasonable accommodation (RA) for people with disabilities (PwD). Yet, little is known about the extent to which managerial views of RA shape attitudes toward PwD. The study draws on conservation of resources (COR) and job demands and resources (JD-R) theories to examine the relationship between managerial views of RA availability and implementation ease on attitudes towards hiring PwD.

Design/methodology/approach

In total, 162 full-time managers at a large New Zealand (NZ) healthcare organisation completed an online survey. Moderated multiple regressions were conducted to test the main effects and interactions between perceptions of RA process and attitudes towards hiring PwD.

Findings

The study results indicate that line managers held positive attitudes towards hiring PwD when they viewed RA implementation as easy, particularity around the provision of flexible work arrangements.

Research limitations/implications

This study shows the importance of gaging managers' views of RA processes to understand their attitudes toward PwD and highlights potential linkages between managerial perspectives on RA, PwD experiences in the organisation and the effectiveness of disability support and inclusion initiatives.

Practical implications

RA availability from the organisation is insufficient to elicit positive managerial attitudes toward hiring PwD. Policies and procedures that reduce RA implementation complexity are expected to foster positive managerial attitudes toward PwD and improve employment outcomes for this employee group.

Originality/value

This study is the first to test how managerial attitudes towards hiring PwD are influenced by views of RA availability from the organisation and of RA implementation ease. It also provides a multidimensional measure that captures managerial views of RA availability from the organisation and RA implementation ease.

Workplace accommodation requests: Experiences of barriers and facilitators among deaf and hard-of-hearing

BACKGROUND

Despite the protections afforded by the Americans with Disabilities Act (ADA), workers who are deaf and hard-of-hearing (DHH) face workplace challenges that may require the aid of workplace resources and accommodations. Limited research has been conducted to understand the process of accommodation requests among DHH workers.

OBJECTIVE

This qualitative study examined barriers and facilitators to requesting accommodations among DHH workers.

METHODS

Fifty-nine DHH workers, recruited from organizations serving DHH workers across U.S., participated in the study. Participants' open-ended survey responses were analyzed and coded into themes representing barriers or facilitators to participants' decisions to request or withhold requests for accommodations.

RESULTS

Facilitators to accommodation request include an employee's effective use of self-efficacy and self-advocacy; supportive work environments; and the presence of peers with disabilities. Barriers to accommodation requests include the anticipation of negative perception of stigmatization in the workplace; lack of knowledge related to accommodations and ADA; absence of workplace support; ineffectual workplace structure, policies, or procedures; concerns surrounding costs; and physical and access barriers in the workplace.

CONCLUSION

To fulfill the workers' rights as guaranteed by the ADA, and to best serve the interests of the workplace, strategies are highlighted on how to assist DHH employees to take advantage of workplace accommodations with aims to promote job retention and success.

Developing a tool for disability accommodation complexity: A sequential mixed study

BACKGROUND

For disability accommodation (DA) decision-making/planning processes to unfold successfully, an understanding of the factors influencing DA complexity and a reliable tool for measuring such complexity are needed. The current literature does not provide sufficient knowledge on either topic.

OBJECTIVE

We attempted to explore the factors influencing DA complexity and develop a DA complexity scale in three phases through the sequential mixed approach.

METHOD

The study used an exploratory sequential mixed method in three phases. In phase 1, a qualitative survey of 335 supervisors with recent DA management experience was conducted, and the data were analyzed using a thematic approach to identify and evaluate DA complexity factors. In phase 2, qualitative results were transformed into items to construct a DA complexity scale. Later, the scale was tested using data from a separate quantitative cross-sectional survey of 303 supervisors with recent DA management experience. In phase 3, another quantitative cross-sectional study of 307 supervisors with recent DA management experience to evaluate the validity of the scale and its dimensions.

RESULTS

In Phase 1, we identified 12 factors influencing DA complexity. In Phase 2, the DA complexity scale loaded 29 items in nine dimensions, which represented the factors influencing DA complexity. In Phase 3, DA complexity positively influenced supervisors' job demand and stress, and negatively influenced their work motivation, organizational commitment, and supervisors' perceptions about their relationships with employees with disabilities.

CONCLUSION

This study enriches the DA literature by offering an in-depth understanding of DA complexity and a scale to measure it.

Role and Responsibilities of Supervisors in the Sustainable Return to Work of Workers Following a Work-Related Musculoskeletal Disorder

Purpose Supervisors play an important role during the return to work (RTW) of injured workers. Yet little research has been done on the actions associated with this role or the contexts in which they are taken. The purpose of this study was to develop courses of action to promote supervisors' involvement in the process aimed at achieving sustainable RTW for workers following a work-related musculoskeletal disorder (MSD), and to verify their pertinence, feasibility, and applicability in practice. Methods A two-phase qualitative method was used. (1) Secondary content analysis of 46 interviews of 14 workers post-MSD and 32 other actors in the RTW process, conducted during a prior case study, yielded proposals for courses of action composed of specific actions for supervisors. (2) The pertinence, feasibility, and applicability of these courses of action and specific actions were explored, first, through a self-administered questionnaire to initiate individual reflection, and later in greater depth through focus groups to identify the different contexts in which they might be applicable. Thematic analysis was performed for each phase. Results Eight proposed courses of action, including specific concrete actions and conditions influencing supervisors' involvement, were developed by the researchers and generally perceived as pertinent and feasible by the participants. Several aspects of the organizational context appeared to influence implementation of these courses of action within the organizations. Conclusion Organizational context appears to influence the application of these courses of action, as do the conditions under which they are implemented.

Work disability negotiations between supervisors and occupational health services: factors that support supervisors in work disability management

PURPOSE

A work disability negotiation takes place between a supervisor, the disabled employee and the occupational health service (OHS) to support the disabled employee in returning to their work, often with temporary work accommodation. The objective of this study was to define the factors of a work disability negotiation with OHS that supported or hindered supervisors in their task/role in work disability management.

METHODS

The study setting comprised two parts: the creation of survey questions and the actual survey of supervisors (N = 254) from six public and private organizations in Finland. Of these, 133 (52%) had participated in one or more work disability negotiations. The responses covered about 240 work disability cases and considerably more negotiations.

RESULTS

The study identified four key elements that the supervisors expressed as major success factors in the negotiations. First, it was crucial that the supervisors learned about the employee's health restrictions and understood the issues relating to their work disability. Second, the parties should aim for common solutions and conclusions through collaboration. Third, active participation of all the negotiation parties is important. The supervisors gave a high rating to OHS taking their views seriously. Last, the supervisors appreciated collaboration in a constructive atmosphere.

CONCLUSION

In order for a negotiation to help supervisors in their challenges, it should reach solutions, conclusions and a restructured comprehension of the work disability problem in a constructive atmosphere and with active communication between stakeholders.

Obstacles to returning to work with chronic pain: in-depth interviews with people who are off work due to chronic pain and employers

Background

The global burden of chronic pain is growing with implications for both an ageing workforce and employers. Many obstacles are faced by people with chronic pain in finding employment and returning to work after a period of absence. Few studies have explored obstacles to return-to-work (RTW) from workers’ and employers’ perspectives. Here we explore views of both people in pain and employers about challenges to returning to work of people who are off work with chronic pain.

Methods

We did individual semi-structured interviews with people who were off work (unemployed or off sick) with chronic pain recruited from National Health Service (NHS) pain services and employment services, and employers from small, medium, and large public or private sector organisations. We analysed data using the Framework method.

Results

We interviewed 15 people off work with chronic pain and 10 employers. Obstacles to RTW for people with chronic pain spanned psychological, pain related, financial and economic, educational, and work-related domains. Employers were concerned about potential attitudinal obstacles, absence, ability of people with chronic pain to fulfil the job requirements, and the implications for workplace relationships. Views on disclosure of the pain condition were conflicting with more than half employers wanting early full disclosure and two-thirds of people with chronic pain declaring they would not disclose for fear of not getting a job or losing a job. Both employers and people with chronic pain thought that lack of confidence was an important obstacle. Changes to the job or work conditions (e.g. making reasonable adjustments, phased return, working from home or redeployment) were seen by both groups as facilitators. People with chronic pain wanted help in preparing to RTW, education for managers about pain and supportive working relationships.

Conclusions

People with chronic pain and employers may think differently in terms of perceptions of obstacles to RTW. Views appeared disparate in relation to disclosure of pain and when this needs to occur. They appeared to have more in common regarding opinions about how to facilitate successful RTW. Increased understanding of both perspectives may be used to inform the development of improved RTW interventions.

The work of return to work. Challenges of returning to work when you have chronic pain: a meta-ethnography

AIMS

To understand obstacles to returning to work, as perceived by people with chronic non-malignant pain and as perceived by employers, and to develop a conceptual model.

DESIGN

Synthesis of qualitative research using meta-ethnography.

DATA SOURCES

Eleven bibliographic databases from inception to April 2017 supplemented by citation tracking.

REVIEW METHODS

We used the methods of meta-ethnography. We identified concepts and conceptual categories, and developed a conceptual model and line of argument.

RESULTS

We included 41 studies. We identified three core categories in the conceptual model: managing pain, managing work relationships and making workplace adjustments. All were influenced by societal expectations in relation to work, self (self-belief, self-efficacy, legitimacy, autonomy and the meaning of work for the individual), health/illness/pain representations, prereturn to work support and rehabilitation, and system factors (healthcare, workplace and social security). A mismatch of expectations between the individual with pain and the workplace contributed to a feeling of being judged and difficulties asking for help. The ability to navigate obstacles and negotiate change underpinned mastering return to work despite the pain. Where this ability was not apparent, there could be a downward spiral resulting in not working.

CONCLUSIONS

For people with chronic pain, and for their employers, navigating obstacles to return to work entails balancing the needs of (1) the person with chronic pain, (2) work colleagues and (3) the employing organisation. Managing pain, managing work relationships and making workplace adjustments appear to be central, but not straightforward, and require substantial effort to culminate in a successful return to work.

Employers' Perspectives on Accommodating and Retaining Employees with Newly Acquired Disabilities: An Exploratory Study

Introduction Timely and appropriate accommodations can help employees who experience disabilities stay at work instead of exiting the labor force. Employers can play a critical role in connecting such workers with the accommodations they need. This qualitative study seeks to inform policy makers who want to improve workforce retention outcomes by uncovering factors that affect whether employers provide accommodations to, and ultimately retain, employees with disabilities. Methods We conducted semistructured interviews with a convenience sample of human resources professionals in 14 Arkansas-based employers, yielding detailed information on 50 cases in which an employee developed or disclosed a disability. We analyzed the interviews using a grounded theory approach and compared cases to identify key themes emerging across subgroups of cases. Results Two organization-level factors and four employee-level factors influenced employers' efforts to accommodate and retain employees with disabilities: employer resources; employers' communication with the employee and other stakeholders; employee tenure; employee work performance; active/sedentary nature of employee role; and the severity and type of employees' health conditions. Conclusions Consistent with prior literature, employers with greater access to resources and better ability to communicate generally made greater effort to accommodate and retain employees with disabilities. However, employers in the study did not deploy these resources and processes consistently when making decisions about whether and how to provide accommodations to workers with disabilities; employee-level characteristics affected their actions. Policy makers should consider intervention approaches that reach workers who may be overlooked by employers with scarce resources.