Implementation of the Participatory Approach for Supervisors to Increase Self-Efficacy in Addressing Risk of Sick Leave of Employees: Results of a Cluster-Randomized Controlled Trial

Predicting long-term sickness absence among retail workers after four days of sick-listing

OBJECTIVE

This study tested and validated an existing tool for its ability to predict the risk of long-term (ie, ≥6 weeks) sickness absence (LTSA) after four days of sick-listing.

METHODS

A 9-item tool is completed online on the fourth day of sick-listing. The tool was tested in a sample (N=13 597) of food retail workers who reported sick between March and May 2017. It was validated in a new sample (N=104 698) of workers (83% retail) who reported sick between January 2020 and April 2021. LTSA risk predictions were calibrated with the Hosmer-Lemeshow (H-L) test; non-significant H-L P-values indicated adequate calibration. Discrimination between workers with and without LTSA was investigated with the area (AUC) under the receiver operating characteristic (ROC) curve.

RESULTS

The data of 2203 (16%) workers in the test sample and 14 226 (13%) workers in the validation sample was available for analysis. In the test sample, the tool together with age and sex predicted LTSA (H-L test P=0.59) and discriminated between workers with and without LTSA [AUC 0.85, 95% confidence interval (CI) 0.83-0.87]. In the validation sample, LTSA risk predictions were adequate (H-L test P=0.13) and discrimination was excellent (AUC 0.91, 95% CI 0.90-0.92). The ROC curve had an optimal cut-off at a predicted 36% LTSA risk, with sensitivity 0.85 and specificity 0.83.

CONCLUSION

The existing 9-item tool can be used to invite sick-listed retail workers with a ≥36% LTSA risk for expedited consultations. Further studies are needed to determine LTSA cut-off risks for other economic sectors.

[Enabling Workers to Preserve Their Mental Health: What are Ocupational Therapists Doing?]

Description. Les ergothérapeutes accompagnent les travailleurs ayant subi une atteinte à la santé mentale dans leur processus de retour au travail, mais peuvent aussi favoriser le maintien d’une participation saine à long terme. Peu d’écrits scientifiques permettent de comprendre ce rôle émergent. But. Décrire les interventions des ergothérapeutes en regard de l’habilitation des travailleurs à préserver leur santé mentale. Méthodologie. Selon un devis de recherche qualitatif descriptif, des entrevues ont été menées auprès de 19 ergothérapeutes œuvrant en réadaptation socioprofessionnelle. Résultats. Les ergothérapeutes mettent en place 31 interventions réparties en huit catégories. Ces interventions sont principalement axées sur le travailleur lui-même; celles impliquant l’environnement étant moins développées. Conséquences. Les interventions décrites avec spécificité offrent des leviers concrets que les ergothérapeutes peuvent utiliser dans leur pratique. Des travaux de recherche sont toutefois requis pour évaluer l’efficacité de ces interventions.

Promoting Factors to Stay at Work Among Employees With Common Mental Health Problems: A Multiple-Stakeholder Concept Mapping Study

Most individuals affected by common mental health problems are employed and actually working. To promote stay at work by workplace interventions, it is crucial to understand the factors perceived by various workplace stakeholders, and its relative importance. This concept mapping study therefore explores perspectives of employees with common mental health problems (n = 18), supervisors (n = 17), and occupational health professionals (n = 14). Per stakeholder group, participants were interviewed to generate statements. Next, each participant sorted these statements on relatedness and importance. For each group, a concept map was created, using cluster analysis. Finally, focus group discussions were held to refine the maps. The three concept maps resulted in several clustered ideas that stakeholders had in common, grouped by thematic analysis into the following meta-clusters: (A) Employee’s experience of autonomy in work (employee’s responsibility, freedom to exert control, meaningful work), (B) Supervisor support (being proactive, connected, and involved), (C) Ways to match employee’s capacities to work (job accommodations), (D) Safe social climate in workplace (transparent organizational culture, collective responsibility in teams, collegial support), and (E) professional and organizational support, including collaboration with occupational health professionals. Promoting stay at work is a dynamic process that requires joined efforts by workplace stakeholders, in which more attention is needed to the interpersonal dynamics between employer and employee. Above all, a safe and trustful work environment, in which employee’s autonomy, capacities, and needs are addressed by the supervisor, forms a fundamental base to stay at work.

Prevention of sick leave at the workplace: design of a cluster-randomized controlled trial of a problem-solving intervention among employees with common mental disorders

Background

Common mental disorders are highly prevalent in the working population, affecting about 1 in 5 persons in the Organisation for Economic Co-operation and Development countries. About 30% of those affected have a first period of sick leave. Despite several attempts to reduce the risk of sick leave among employees with common mental disorders, there is a lack of knowledge about effective, preventive interventions which aim to reduce such risks. This protocol describes the design of a study to evaluate the effectiveness of a problem-solving intervention delivered by first-line managers to employees with common mental disorders on the prevention of sick leave during the 12-month follow-up.

Methods/design

The study applies a two-armed cluster-randomized trial design of a problem-solving intervention conducted in private-sector companies. First-line managers are randomized into intervention- or control groups by computer-generated random numbers, allocation ratio 1:1. Employees are eligible if at risk for future sick leave due to common mental disorders. These are identified by self-reported psychological health measured by the General Health Questionnaire 12-item, cut-off ≥3, or a positive answer to risk of sick leave.

The intervention is based on problem-solving principles. It involves the training of the first-line managers who then deliver the intervention to employees identified at risk of sick leave. First-line managers in the control group receives a lecture. Primary outcome is number of registered days of sick leave due to common mental disorders during the 12-month follow-up. Secondary outcomes are general health, psychological symptoms, work performance, work ability and psychosocial work environment. A process evaluation will examine the intervention’s reach, fidelity, dose delivered, dose received, satisfaction and context. Research assistants managing the screening procedure, outcome assessors and employees are blinded to randomization and allocation.

Discussion

The study includes analyses of the intervention’s effectiveness and an alongside process evaluation. Methodological strengths and limitations, for example the risk of selection bias, attrition and risk of contamination are discussed.

Trial registration

Clinicaltrials.gov NCT04975750 Date of registration: 08/16/2021.

Distress, Work Satisfaction, and Work Ability are Mediators of the Relation Between Psychosocial Working Conditions and Mental Health-Related Long-Term Sickness Absence

Purpose This study investigated the effects of psychosocial working conditions on mental health-related long-term sickness absence and whether distress, work satisfaction, burnout, engagement, and work ability mediated the associations between psychosocial working conditions and mental health-related long-term sickness absence. Methods This cohort study included 53,833 non-sick listed workers who participated in occupational health surveys between 2010 and 2013. The effects of the individual psychosocial working conditions on mental long-term sickness absence were analyzed using univariable and multivariable logistic regression analyses. Mediation analyses were performed to examine the mediating role of distress, burnout, work satisfaction, engagement, and work ability between psychosocial working conditions and mental long-term sickness absence. The mediation analyses were performed using structural equation modeling. Results Role clarity, cognitive demands, emotional demands, work variety, learning opportunities, and co-worker support were related to mental health-related long-term sickness absence after adjustment for other working conditions. The relationship between emotional demands and mental health-related long-term sickness absence was the strongest, OR 1.304 (p < 0.001, 95% CI 1.135 to 1.498). The relation between psychosocial working conditions and mental health-related long-term sickness absence was mediated by distress, burnout, work satisfaction, engagement, and work ability. Distress was the most important mediator between psychosocial working conditions and mental health-related long-term sickness absence. Conclusions Psychosocial working conditions are related to mental health-related long-term sickness absence. After correction for other working conditions, the association between emotional demands and mental health-related long-term sickness absence was the strongest. Psychosocial working conditions are indirectly related to mental health-related long-term sickness absence through mediation by distress, work satisfaction, and work ability.

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.