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Stagg AL, Madan I, Fear N, Stevens MJ, Wainwright E, Hoving JL, Macfarlane GJ, Hollick R, Morton L. Do current methods of measuring the impact of chronic pain on work reflect the experience of working-age adults? An integrated mixed-methods systematic narrative review. Pain 2024:00006396-990000000-00529. [PMID: 38381946 DOI: 10.1097/j.pain.0000000000003169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/03/2023] [Indexed: 02/23/2024]
Abstract
ABSTRACT Chronic pain affects individuals' work participation. The impact of chronic pain on work has historically been measured through sickness absence, though it is now appreciated that the impacts on work are far wider. This mixed-methods review aimed to identify the full range of impacts of pain on work in addition to impacts that are currently measured quantitatively to inform the development of a new questionnaire assessing the wider impacts of chronic pain on work. MEDLINE, Embase, PsychINFO, and CINAHL were searched for studies that included quantitative measures of the impact of chronic pain on work and for qualitative studies where individuals described impacts of their chronic pain on work. Quantitative measures, and text from qualitative studies, were analysed thematically. A thematic framework was developed for establishing the types of impacts measured or described in the literature. Forty-four quantitative and 16 qualitative papers were identified. The literature described impacts within 5 areas: changes at work and to working status; aspects of the workplace and work relationships; pain and related symptoms at work; psychological factors; and factors and impacts outside the work environment related to work. Quantitative measures mainly assessed impacts related to the quantity and quality of work (29 of 42 measures). Seventeen aspects were only discussed within the qualitative literature. This study identifies a discrepancy between the impacts that have been the focus of quantitative measures and the range that individuals working with chronic pain experience and highlights the need for a new measure assessing a wider range of issues.
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Affiliation(s)
- Anne L Stagg
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (Guy's & St Thomas' NHS Foundation Trust and King's College London), London, United Kingdom
| | - Ira Madan
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (Guy's & St Thomas' NHS Foundation Trust and King's College London), London, United Kingdom
| | - Nicola Fear
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (King's Centre for Military Health Research, King's College London), London, United Kingdom
| | - Martin J Stevens
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - Elaine Wainwright
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - Jan L Hoving
- Department of Public and Occupational Health, Cochrane Work, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gary J Macfarlane
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - Rosemary Hollick
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - LaKrista Morton
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
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Rydland HT, Bentsen HL, Ervik R, Grønning K, Islam K, Kjerstad E, Skogedal Lindén T. Promoting labour market inclusion of the chronically ill: a scoping review of Scandinavian countries' efforts. Scand J Public Health 2023; 51:1097-1107. [PMID: 35535443 PMCID: PMC10642227 DOI: 10.1177/14034948221096005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 03/03/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This article is a scoping review of efforts in labour market inclusion of the chronically ill in the Scandinavian countries, a research area that has received much political as well as research attention in recent years. The aim of the review was to identify promising strategies and the need for further research. METHODS Six electronic databases were searched for literature published between 2015 and 2020. We included peer-reviewed articles that studied the effect of measures, aimed at the workplace or at the individual, that are intended to increase participation. Our search resulted in 2718 articles; our screening procedures resulted in 47 included articles. RESULTS Among the included studies, musculoskeletal problems (17 articles) and mental health problems (29 articles) were the most frequent chronic conditions. Multimodal occupational rehabilitation programmes directed towards the individual employee were the most frequent interventions (30 articles). Return to work (24 articles) and sickness absence (12 articles) were the most common outcomes. About half (25 articles) of the included studies reported a positive impact of the intervention on work inclusion of the chronically ill. CONCLUSIONS Our review found little evidence of how government programmes directed towards the supply side of the labour market succeed in including the chronically ill. Our review further indicated that multidisciplinary workplace interventions have a substantial effect. We also identified a significant lack of research on the effect of various governmental policies and programmes, including local health, work and welfare services, and limited coordination and cooperation between health and work services professions.
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Affiliation(s)
| | | | - Rune Ervik
- NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Kjersti Grønning
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kamrul Islam
- NORCE Norwegian Research Centre AS, Bergen, Norway
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3
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Silva-Junior JS, Martinez MC, Sekiya FS, de Miranda CB, Fischer FM. Return to work after sick leave due to musculoskeletal disorder or injury: a longitudinal study conducted in Brazil. BMC Public Health 2023; 23:1881. [PMID: 37770862 PMCID: PMC10540424 DOI: 10.1186/s12889-023-16789-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Musculoskeletal disorders and injuries (MSDI) are conditions that affect the locomotor system characterized by pain and impairment of functionality. They are the leading cause of years lived with disability. The aim of this study was to analyze the factors that influence the return to work (RTW) among workers on sick leave due to MSDI. METHODS: A longitudinal study was conducted in the city of São Paulo, Brazil, between 2020-2022. The participants were 216 workers who required social security compensation due to MSDI. They filled out online questionnaires about their sociodemographic characteristics, health risk behaviors, work characteristics and health conditions. They were followed for 365 days after their first day of sick leave. A Cox regression was performed to identify the factors that influenced their first RTW. RESULTS Most participants were male (53.0%), mean age was 39.5 years (SD 10.6), 70.4% returned to work within the one-year follow-up period. The mean duration of sick leave was 192.6 days. Factors associated with a lower RTW were age 40 years and older (HR 0.54; 95%CI 0.39-0.76) and the interaction between perceptions of the need for improvement in the physical and psychological domains of quality of life (HR 0.67; 95%CI 0.48-0.94). CONCLUSIONS Occupational healthcare professionals should pay greater attention to patients who are aging and those with perceived worse physical and psychological conditions, in order to facilitate the reintegration process and promote sustained RTW after sick leave due to musculoskeletal disorder or injury.
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Affiliation(s)
- João Silvestre Silva-Junior
- Department of Forensic Medicine, Bioethics, Occupational Medicine and Physical and Rehabilitation Medicine, University of São Paulo Medical School (FMUSP), São Paulo, Brazil.
- Department of Medicine, São Camilo University Center, São Paulo, Brazil.
- Occupational Medicine Residency Program, Clinics Hospital, University of São Paulo Medical School (FMUSP), São Paulo, Brazil.
| | | | - Felipe Seiti Sekiya
- Occupational Medicine Residency Program, Clinics Hospital, University of São Paulo Medical School (FMUSP), São Paulo, Brazil
| | - Cristiano Barreto de Miranda
- General Coordination of Occupational Health Surveillance, Department of Environmental Health Surveillance and Occupational Health, Secretariat for Health and Environment Surveillance, Ministry of Health, Brasília, Brazil
| | - Frida Marina Fischer
- Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo, Brazil
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Nilsen DA, Nissen O, Nordfjærn T, Hara KW, Stiles TC. Who Returns to work? Exploring the Role of Interpersonal Problems in Occupational Rehabilitation. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:528-537. [PMID: 37340280 PMCID: PMC10495481 DOI: 10.1007/s10926-022-10091-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 06/22/2023]
Abstract
PURPOSE Current interventions designed to facilitate return to work (RTW) after long-term sick leave show weak effects, indicating the need for new approaches to the RTW process. The importance of social relationships in the workplace is widely recognized in existing RTW literature, but very little is known about the role of the interpersonal problems of the returning worker. Current research indicates that a subset of these - hostile-dominant interpersonal problems - give particular disadvantages in several life areas. This prospective cohort study aims to test whether higher levels of interpersonal problems predict lower likelihood of RTW when controlling for symptom levels (H1); and whether higher levels of hostile-dominant interpersonal problems specifically predict lower likelihood of RTW (H2). METHODS 189 patients on long-term sick leave completed a 3½-week transdiagnostic RTW program. Before treatment, self-reported interpersonal problems, chronic pain, insomnia, fatigue levels, anxiety and depression were collected. RTW data for the following year were collected from the Norwegian Labour and Welfare Administration. RESULTS A multivariable binary logistic regression analysis found that (H2) hostile-dominant interpersonal problems significantly predicted RTW (OR = 0.44, [95% CI: 0.19, 0.98], p = .045), while a corresponding analysis (H1) found that general interpersonal problems did not. CONCLUSION Hostile-dominant interpersonal problems negatively predict RTW after long-term sick leave, suggesting an overlooked factor in the field of occupational rehabilitation. The findings could open up new avenues for research and interventions entailed to individuals in the field of occupational rehabilitation.
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Affiliation(s)
| | - Oda Nissen
- St. Olav's University Hospital, Trondheim, Norway
| | - Trond Nordfjærn
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Karen Walseth Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tore C Stiles
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Duong HP, Léger B, Scholz-Odermatt SM, Burrus C, Vuistiner P, Konzelmann M, Luthi F. Healthcare Costs, Time to Fitness for Work, and Related Factors in Chronic Complex Regional Pain Syndrome: A Comparative and Longitudinal Study of 5-Year Follow-Up. J Pain Res 2023; 16:683-693. [PMID: 36915280 PMCID: PMC10007986 DOI: 10.2147/jpr.s400659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
Purpose To assess and compare the healthcare costs, time to fitness for work (TFW) between chronic complex regional pain syndrome (CRPS) and non-CRPS; and identify factors associated with these outcomes in a comparative longitudinal study. Patients and Methods 148 patients with chronic CRPS of the hand and 273 patients with chronic hand impairments but without CRPS (non-CRPS) were admitted at a Swiss rehabilitation clinic between 2007 and 2016. Healthcare costs and TFW were retrieved from insurance data over 5 years after the accident. Socio-demographic factors, biopsychosocial complexity measured by means of the INTERMED questionnaire, pain intensity and DASH disability scores were collected during rehabilitation. Generalized estimation equations and Cox proportional-hazards models were used to identify factors associated with outcomes. Results Healthcare costs were increased by 20% for the CRPS versus non-CRPS group (coefficient = 1.20, 95% CI = 1.08-1.35, p<0.001). The median TFW was longer for CRPS than non-CRPS patients (816 vs 672 days, p = 0.02). After adjusting for covariates, TFW did not differ between the two groups (hazard ratio = 0.94, 95% CI = 0.73-1.21, p=0.61). For CRPS patients, higher healthcare costs were associated with severe or moderate initial injury, high INTERMED or DASH disability scores. Longer TFW were associated with severe initial injury, low educational level, no work contract, and high INTERMED or DASH disability scores. Conclusion Overall, the healthcare costs were higher for CRPS than non-CRPS patients, but the TFW was comparable. We demonstrated also the significant associations of disability and biopsychosocial factors with the healthcare costs and TFW in CRPS patients.
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Affiliation(s)
- Hong Phuoc Duong
- Department of Medical Research, Clinique romande de réadaptation, Sion, 1951, Switzerland
| | - Bertrand Léger
- Department of Medical Research, Clinique romande de réadaptation, Sion, 1951, Switzerland
| | - Stefan Markus Scholz-Odermatt
- Department of Statistics, Sammelstelle für die Statistik der Unfallversicherung (SSUV), c/o Swiss Accident Insurance Fund (Suva), Lucerne, 6002 Switzerland
| | - Cyrille Burrus
- Department of Medical Research, Clinique romande de réadaptation, Sion, 1951, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, 1951, Switzerland
| | - Philippe Vuistiner
- Department of Medical Research, Clinique romande de réadaptation, Sion, 1951, Switzerland
| | - Michel Konzelmann
- Department of Medical Research, Clinique romande de réadaptation, Sion, 1951, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, 1951, Switzerland
| | - François Luthi
- Department of Medical Research, Clinique romande de réadaptation, Sion, 1951, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, 1951, Switzerland.,Department of Rheumatology and Rehabilitation, Hôpital Orthopédique, University and University Hospital of Lausanne, Lausanne, 1011, Switzerland
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Friedli T, Brodbeck J, Gantschnig BE. Associations between social integration, participation and productivity loss among persons with chronic pain: a registry based cross sectional study. BMC Musculoskelet Disord 2022; 23:956. [PMID: 36333712 PMCID: PMC9636815 DOI: 10.1186/s12891-022-05896-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To examine associations between factors of social inclusion and participation and productivity loss in employed persons with chronic pain, assessed for an interprofessional pain rehabilitation programme. We hypothesized that factors of social inclusion and participation and work related social factors are significantly associated with productivity when experiencing chronic pain and we expected a moderate effect. Methods Cross-sectional study using data collected prospectively in an interprofessional patient registry for chronic pain. The primary end point was productivity loss, measured with the iMTA Productivity Costs Questionnaire. We included data from 161 individuals. To be included, persons had to be 18 years old or older, in paid work, and had to have a medical diagnosis of chronic pain syndrome with actual or potential tissue damage. In addition, participants had to have indicators of significant impairments in psychosocial functions. Results Linear regression analysis showed that a highly stressful professional situation, frequent problems regarding the compatibility of the family and job and not being Swiss were associated with a significantly higher total productivity loss. Similar results were found for productivity loss in paid work. However, problems concerning the compatibility of the family and job did not reach the significance level for productivity loss in paid work. Conclusion The results of this study underscore the importance of factors of social inclusion and participation for interprofessional rehabilitation programmes to manage chronic pain especially when focussing on productivity loss.
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7
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Friedli T, Gantschnig BE. The role of contextual factors on participation in the life area of work and employment after rehabilitation: A qualitative study on the views of persons with chronic pain. Work 2021; 71:119-132. [PMID: 34924419 PMCID: PMC8842774 DOI: 10.3233/wor-205173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND: A deeper understanding of how contextual factors affect the ability to participate in the life area of work and employment despite chronic musculoskeletal pain is needed as a basis for interprofessional rehabilitation programs. OBJECTIVE: To investigate which contextual factors influence rehabilitation program clients’ ability to participate in the life area of work and employment, and how they do this. METHODS: Nested case study using a realist evaluation framework of interprofessional interventions. Qualitative content analysis of problem-centered interviews to identify influential context-mechanism-outcome configurations. RESULTS: We identified several important context-mechanism-outcome configurations. In the pre-interventional phase, socioeconomic and environmental factors affected two mechanisms, “exhaustion” and “discrimination”. In the intra-interventional phase, the social skills of health professionals and opportunities for discussion with peers affected the ability of program participants to engage with program content. In the post-intervention phase, volitional competences of the social system affected the sustainable application of program content in everyday life. CONCLUSION: The identified context-mechanism-outcome configurations shows that the ability to participate in the life area of work is interdependent with the ability to participate in other areas of life. In practice and research, assessment and treatment should be carried out based on this understanding.
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Affiliation(s)
- Thomas Friedli
- Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, and University of Bern
| | - Brigitte E Gantschnig
- Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, and University of Bern.,Institute of Occupational Therapy, School ofHealth Professions ZHAW Zurich University of Applied Sciences, Switzerland
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8
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Gane EM, Plinsinga ML, Brakenridge CL, Smits EJ, Aplin T, Johnston V. The Impact of Musculoskeletal Injuries Sustained in Road Traffic Crashes on Work-Related Outcomes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111504. [PMID: 34770019 PMCID: PMC8582890 DOI: 10.3390/ijerph182111504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Musculoskeletal injuries occur frequently after road traffic crashes (RTCs), and the effect on work participation is not fully understood. The primary aim of this review was to determine the impact of sustaining a musculoskeletal injury during an RTC on the rate of return to work (RTW), sick leave, and other work outcomes. The secondary aim was to determine factors associated with these work-related outcomes. An electronic search of relevant databases to identify observational studies related to work and employment, RTC, and musculoskeletal injuries was conducted. Where possible, outcome data were pooled by follow-up period to answer the primary aim. Fifty-three studies were included in this review, of which 28 were included in meta-analyses. The pooled rate of RTW was 70% at 1 month, 67% at 3 months, 76% at 6 months, 83% at 12 months, and 70% at 24 months. Twenty-seven percent of participants took some sick leave by one month follow-up, 13% by 3 months, 23% by 6 months, 36% by 12 months, and 22% by 24 months. Most of the factors identified as associated with work outcomes were health-related, with some evidence also for sociodemographic factors. While 70% of people with RTC-related musculoskeletal injury RTW shortly after accident, many still have not RTW two years later.
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Affiliation(s)
- Elise M. Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (T.A.); (V.J.)
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane 4102, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane 4102, Australia
- Correspondence:
| | - Melanie L. Plinsinga
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
| | - Charlotte L. Brakenridge
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
| | - Esther J. Smits
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (T.A.); (V.J.)
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane 4032, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (T.A.); (V.J.)
- Recover Injury Research Centre, The University of Queensland, Brisbane 4066, Australia; (M.L.P.); (C.L.B.); (E.J.S.)
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9
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Johansen T, Øyeflaten I, Eriksen HR, Lyby PS, Dittrich WH, Holsen I, Jakobsen H, Del Risco Kollerud R, Jensen C. Sustained Attention and Working Memory Predict the Number of Days on Health-Related Benefits in the Year Following Occupational Rehabilitation. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:592-603. [PMID: 33471320 PMCID: PMC8298247 DOI: 10.1007/s10926-020-09944-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
Purpose The objective of this study was to investigate the association between cognitive and emotional functioning and the number of days on health-related benefits such as sick leave, work assessment allowance and disability pension. We investigated whether cognitive and emotional functioning at the start of rehabilitation and the change from the start to the end of rehabilitation predicted the number of days on health-related benefits in the year after occupational rehabilitation. Methods A sample of 317 individuals (age 19-67 years), mainly diagnosed with a musculoskeletal or mental and behavioural ICD-10 disorder, participated. The sample was stratified depending on the benefit status in the year before rehabilitation. Those receiving health-related benefits for the full year comprised the work assessment allowance and disability pension (WAA) group and those receiving benefits for less than a year comprised the sick leave (SL) group. The participants were administered cognitive and emotional computerised tests and work and health questionnaires at the beginning and end of rehabilitation. The cumulative number of days on health-related benefits during 12 months after rehabilitation was the primary outcome variable and age, gender, educational level, subjective health complaints, anxiety, and depression were controlled for in multiple regression analyses. Results The WAA group (n = 179) was significantly impaired at baseline compared to the SL group (n = 135) in focused attention and executive function, and they also scored worse on work and health related variables. Higher baseline scores and change scores from the start to the end of rehabilitation, for sustained attention, were associated with fewer number of health-related benefit days in the WAA group, while higher baseline scores for working memory were associated with fewer number of health-related benefit days in the SL group. Conclusions New knowledge about attention and memory and return to work in individuals with different benefit status may pave the way for more targeted programme interventions. Rehabilitation programmes could benefit from designing interventions that respectively improve sustain attention and working memory related to working life in individuals on sick leave or work assessment allowance and disability pension.
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Affiliation(s)
- Thomas Johansen
- Norwegian National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Norway.
| | - Irene Øyeflaten
- Norwegian National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Norway
- NORCE, Norwegian Research Centre, Bergen, Norway
| | - Hege R Eriksen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Winand H Dittrich
- FOM Hochschule, KCI Competence Center for Behavioral Economics, Frankfurt, Germany
| | - Inge Holsen
- Red Cross Haugland Rehabilitation Center, Flekke, Norway
| | | | - Ruby Del Risco Kollerud
- Norwegian National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Norway
| | - Chris Jensen
- Norwegian National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Norway
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10
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Svärd V, Friberg E, Azad A. How People with Multimorbidity and Psychosocial Difficulties Experience Support by Rehabilitation Coordinators During Sickness Absence. J Multidiscip Healthc 2021; 14:1245-1257. [PMID: 34103925 PMCID: PMC8178701 DOI: 10.2147/jmdh.s308840] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/05/2021] [Indexed: 12/26/2022] Open
Abstract
Purpose People with multimorbidity face a range of barriers in healthcare, and there is little knowledge about their challenges with regard to return-to-work (RTW). Rehabilitation coordinators, a new function in Swedish healthcare, support people in the RTW process. The present study had two aims: to explore what problems and barriers people with multimorbidity experience during their rehabilitation and RTW process and to explore in which domains the coordinators’ support is perceived to be of importance. Methods Interviews were conducted with 12 persons with multimorbidity who had contact with a rehabilitation coordinator during their sickness absence. Thematic analysis was guided by the case-management ecological model; this analysis was revised and adapted to the Swedish context. Results The participants experienced problems in all domains of the model, namely: “the healthcare system”, “the labor market and the workplace system”, “the sickness insurance system”, and “the personal system”. Rehabilitation programs that did not accommodate combinations of diseases, social complexities and needs were felt to lead to worse symptoms, thus hindering rather than promoting RTW. An overall finding regarding support by coordinators is that interventions, regardless of domain, were felt to be valuable for people with multimorbidity. The coordinator was perceived to give most support by providing advice about and coordination with healthcare and employers. Sometimes the coordinator gave advice and coordination regarding the Social Insurance Agency, very occasionally the Public Employment Services. The coordinator gave least advice and coordination about social difficulties that hindered rehabilitation and RTW processes. Conclusion People with multimorbidity perceive rehabilitation coordinator interventions as important in all domains investigated. Lack of advice and coordination, or rehabilitation programs that were not modified to the complexities of individual’s circumstances, were associated with prolonged sickness absence, worse health, or social risk factors not being recognized.
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Affiliation(s)
- Veronica Svärd
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden.,Department of Social Work in Health, Karolinska University Hospital, Stockholm, SE-171 76, Sweden.,Department of Social Work, Södertörn University, Huddinge, SE-141 89, Sweden
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden
| | - Azadé Azad
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden.,Department of Psychology, Stockholm University, Stockholm, SE-114 19, Sweden
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11
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Hedlund Å. An overlooked concept? Intention to return to work among individuals on sick leave due to common mental disorders: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:602-611. [PMID: 33506561 DOI: 10.1111/hsc.13293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 06/12/2023]
Abstract
Intention to return to work (RTW) is an important predictor of actual RTW among individuals on sick leave in general. However, it is not known whether this is also the case for individuals with common mental disorders (CMDs). Because CMDs are a leading cause of disability worldwide, the RTW process is often more complex and sick leave periods are longer than for other diagnoses. Thus, it is important to focus solely on this group. The purpose of this scoping review was to summarise studies targeting individuals' RTW intention and its importance for actual RTW after sick leave due to CMDs. Studies relevant for the aim were identified by a structured searching in three electronic databases (PubMed, CINAHL and PsycINFO) from their inception until the end of June 2020, as well as grey literature and reference lists of included articles. To cover all aspects of "intention", close concepts such as "expectation" and "willingness" were searched for as well. After the selection process, 10 original research papers were included in the review: eight quantitative and two qualitative. Nine of the studies used the concept "expectation" and one "intention". There was also a lack of consistency in measurements across studies. However, they showed that intention (expectation) was a significant predictor of actual RTW. The conclusion is that RTW intention among individuals after sick leave due to CMDs has been narrowly investigated, with a lack of consistency in measurements. Future research should use behavioural-psychological theories to cover the concept "intention" in a more comprehensive and consistent manner.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
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Eftedal M, Tveito TH, Gensby U, Islam MK, Lie SA, Aasland G, Kostveit S, Jensen C. Comparing two interdisciplinary occupational rehabilitation programs for employees on sick leave: a mixed-method design study protocol. BMC Musculoskelet Disord 2021; 22:158. [PMID: 33563250 PMCID: PMC7871619 DOI: 10.1186/s12891-021-03994-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) and common mental disorders (CMDs) are the most frequent reasons for long-term sick leave and work disability. Occupational rehabilitation programs are used to help employees return to work (RTW). However, knowledge regarding the effect of these programs is scarce, and even less is known about which programs are best suited for which patients. This study aims to compare the RTW results of two interdisciplinary occupational rehabilitation programs in Norway, as well as to examine the delivery and reception of the two programs and explore the active mechanisms of the participants' RTW processes. METHODS/DESIGN We will use a mixed-method convergent design to study the main outcome. Approximately 600 participants will be included in the study. Eligible study participants will be aged 18-60 years old and have been on sick leave due to MSDs, CMDs, or both for at least 6 weeks. Interdisciplinary teams at both participating clinics will deliver complex occupational rehabilitation programs. The inpatient rehabilitation program has a duration of 4 weeks and is full time. The outpatient program has a duration of 3 months and involves weekly sessions. The primary outcome is RTW. Secondary outcomes are differences in the incremental cost for an averted sick leave day, cost utility/benefit, and differences between the programs regarding improvements in known modifiable obstacles to RTW. Subgroup analyses are planned. The researchers will be blinded to the intervention groups when analyzing the quantitative RTW data. DISCUSSION This study aims to provide new insights regarding occupational rehabilitation interventions, treatment targets, and outcomes for different subgroups of sick-listed employees and to inform discussions on the active working mechanisms of occupational rehabilitation and the influence of context in the return-to-work process. TRIAL REGISTRATION Current controlled trials ISRCTN12033424 , 15.10.2014, retrospectively registered.
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Affiliation(s)
- Monica Eftedal
- National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864 Rauland, Norway
| | - Torill H. Tveito
- NORCE Norwegian Research Centre, Bergen, Norway
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Horten, Norway
| | - Ulrik Gensby
- National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864 Rauland, Norway
- Team Working Life Aps, Copenhagen, Denmark
- Adjunct Scientist, Institute for Work and Health, Toronto, Canada
| | - M. Kamrul Islam
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Gro Aasland
- Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Chris Jensen
- National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864 Rauland, Norway
- NORCE Norwegian Research Centre, Bergen, Norway
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Leinonen T, Viikari-Juntura E, Räisänen H, Sundvall S, Kauhanen A, Solovieva S. Does Work Disability Contribute to Trajectories of Work Participation before and after Vocational Labour Market Training for Job Seekers? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1347. [PMID: 33540863 PMCID: PMC7908399 DOI: 10.3390/ijerph18031347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022]
Abstract
The contribution of ill-health to labour market participation in relation to vocational training is unclear. Using nationally representative Finnish register data on 42,691 vocational labour market trainees in 2008-2010, we constructed latent trajectory groups of work participation in the open labour market three years before and after training, identifying groups called "High-High", "High-Low", "Low-High", and "Low-Low". We plotted further patterns of labour market participation within these trajectory groups and, using multinomial logistic regression, examined assignment to these groups focusing on previous work disability status. Those with compared to those without previous work disability had previous employment more often and spent less time in economic inactivity within the two trajectory groups with low pre-training levels of work participation. Having a previous work disability was associated with assignment to the "High-Low" trajectory group of work participation instead of the "High-High" comparison group. The associations of other background factors with the assignment to the different trajectory groups were relatively similar amongst those with and without previous work disability. However, some of these associations were weaker amongst the former. Along with other key background factors, previous work disability should be accounted for when assessing the effects of vocational training.
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Affiliation(s)
- Taina Leinonen
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (E.V.-J.); (S.S.)
| | - Eira Viikari-Juntura
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (E.V.-J.); (S.S.)
| | - Heikki Räisänen
- Ministry of Economic Affairs and Employment, 00023 Helsinki, Finland; (H.R.); (S.S.)
| | - Santtu Sundvall
- Ministry of Economic Affairs and Employment, 00023 Helsinki, Finland; (H.R.); (S.S.)
| | | | - Svetlana Solovieva
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (E.V.-J.); (S.S.)
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McParland JL, Andrews P, Kidd L, Williams L, Flowers P. A scoping review to ascertain the parameters for an evidence synthesis of psychological interventions to improve work and wellbeing outcomes among employees with chronic pain. Health Psychol Behav Med 2021; 9:25-47. [PMID: 34104548 PMCID: PMC8158208 DOI: 10.1080/21642850.2020.1863809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Psychological interventions have mixed effects on improving employee outcomes, partly due to significant variability across studies and a lack of focus on mechanisms of action. This scoping review reports on the parameters of these interventions and examines intervention content to bring clarity to this heterogeneous topic area and direct future systematic review work. Method: Six databases were searched (Cinahl, Cochrane, Embase, Medline, PsychINFO and Web of Science) from April 2010 to August 2020, and a grey literature search was undertaken. Screening was undertaken independently by two authors. The results summarised country, participant and employment characteristics, psychological interventions and work, health and wellbeing outcomes. 10% of the papers were analysed to determine the feasibility of coding intervention descriptions for theory and behaviour change technique (BCT) components. Results: Database searches yielded 9341 titles, of which 91 studies were included. Most studies were conducted in Europe (78%) and included males and females (95%) ranging in age from 31-56.6 years although other demographic, and employment information was lacking. Musculoskeletal pain was common (87%). Psychological interventions commonly included cognitive behavioural therapy (30%) and education (28%). Most studies employed a randomised control trial design (64%). Over half contained a control group (54%). Interventions were delivered in mostly healthcare settings (72%) by health professionals. Multiple outcomes were often reported, many of which involved measuring sickness absence and return-to-work (62%) and pain and general health (53%). Within the feasibility analysis, most papers met the minimum criteria of containing one paragraph of intervention description, but none explicitly mentioned theory or BCTs. Conclusion: Psychological interventions for employees with chronic pain vary in their nature and implementation. We have shown scoping reviews can be used to assess the feasibility of applying tools from health psychology to identify the content of these interventions in future systematic review work to improve intervention development.
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Affiliation(s)
- Joanna L McParland
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Pamela Andrews
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Lisa Kidd
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK
| | - Lynn Williams
- Department of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, Scotland, UK
| | - Paul Flowers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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Sick leave before and after arthroscopic partial meniscectomy due to traumatic meniscal tear. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100040. [DOI: 10.1016/j.ocarto.2020.100040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/03/2020] [Indexed: 11/23/2022] Open
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Jacobsen HB, Glette M, Hara KW, Stiles TC. Metacognitive Beliefs as Predictors of Return to Work After Intensive Return-to-Work Rehabilitation in Patients With Chronic Pain, Chronic Fatigue and Common Psychological Disorders: Results From a Prospective Trial. Front Psychol 2020; 11:70. [PMID: 32116900 PMCID: PMC7025452 DOI: 10.3389/fpsyg.2020.00070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background Metacognitions are associated with work status, but no research has examined to what extent metacognitions before treatment and change in metacognitions following treatment predict return to work (RTW) prospectively. The present study aims to address these two gaps in knowledge. Methods 212 patients on long-term sick leave (>8 weeks) with extensive fatigue, chronic pain conditions and/or mental distress received 3.5 weeks of intensive rehabilitation treatment, aimed at returning them to work. Only part of the population (n = 137) had complete follow-up data on metacognitions. Metacognitions were measured with the Metacognitions Questionnaire 30 (MCQ-30), while RTW was measured using official registry data from the Norwegian Labor and Welfare Service. A registry record of participation in competitive work ≥2.5 days (50% work participation) per week, averaging over 14 weeks, was chosen as an outcome reflecting a successful RTW. The registry data spanned a total of 56 weeks per participant. Results Our results indicated that baseline MCQ scores was not associated with RTW. This was analyzed for the total MCQ score as well as for all subscales. We observed substantial changes in metacognitions following treatment, and a 1-point change in the total sum of metacognitive beliefs was associated with 5% greater odds for successful RTW at all time points (p = 0.040), while a 1-point change on the subscale of beliefs about the need to control thoughts gave 20% greater odds for successful RTW (p = 0.016). Conclusion Metacognitions concerning the need to control thoughts appear to have a significant influence on patients return to work. Here, we observed that a change in these beliefs following treatment substantially affected RTW over the course of 1 year.
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Affiliation(s)
- Henrik B Jacobsen
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,CatoSenteret Rehabilitation Center, Son, Norway
| | - Mari Glette
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Karen W Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian Labour and Welfare Administration, Oslo, Norway
| | - Tore C Stiles
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Early A, Walsh R, Douglas B. The occupational therapy practitioner's role in health promotion, injury prevention, and role participation for the older worker. Work 2019; 63:309-318. [PMID: 31156204 DOI: 10.3233/wor-192924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
As the population of individuals aged sixty-five and older continues to grow, the number of older individuals participating in the workforce rises alongside, with projections estimating as many as 72 million older workers by 2030. Due to this rapid increase in the number of older workers, new challenges to worker health and to health-related productivity will arise in the coming years. Occupational therapy practitioners are uniquely suited to address many of these challenges given their background in activity analysis, assessment and modification of job demands, health promotion and successful aging. However, there is need for continued research in this area to expand the role of the occupational therapy practitioner in prevention and return-to-work interventions focused on the older worker, and to advocate for the value occupational therapy practitioners can contribute to this field.
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Affiliation(s)
- Amy Early
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Ryan Walsh
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Bruce Douglas
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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