A comparative outcome study
The aim of this study was to compare the effectiveness of two individual-level psychotherapy interventions: (a) treatment as usual consisting of cognitive–behavioral therapy (CBT) and (b) work-focused CBT (W-CBT) that integrated work aspects early into the treatment. Both interventions were carried out by psychotherapists with employees on sick leave because of common mental disorders (depression, anxiety, or adjustment disorder). In a quasi-experimental design, 12-month follow-up data of 168 employees were collected. The CBT group consisted of 79 clients, the W-CBT group of 89. Outcome measures were duration until return to work (RTW), mental health problems, and costs to the employer. We found significant effects on duration until RTW in favor of the W-CBT group: full RTW occurred 65 days earlier. Partial RTW occurred 12 days earlier. A significant decrease in mental health problems was equally present in both conditions. The average financial advantage for the employer of an employee in the W-CBT group was estimated at $5,275 U.S. dollars compared with the CBT group. These results show that through focusing more and earlier on work-related aspects and RTW, functional recovery in work can be substantially speeded up within a regular psychotherapeutic setting. This result was achieved without negative side effects on psychological complaints over the course of 1 year. Integrating work-related aspects into CBT is, therefore, a fruitful approach with benefits for employees and employers alike.
Source : Lagerveld, Suzanne E.;Blonk, Roland W. B.;Brenninkmeijer, Veerle;Meij, Leoniek Wijngaards-de;Schaufeli, Wilmar B.
Journal of Occupational Health Psychology, 2012.
DOI : 10.1037/a0027049
The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster controlled trial and focuses on register-based primary outcomes – duration of sickness absence and RTW – and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation.
Source : http://www.sjweh.fi/show_abstract.php?abstract_id=3272
In November 2010, Ontario's Workplace Safety and Insurance Board introduced the new Work Reintegration Program. Many of its features address problems with the old vocational rehabilitation program that were described by Institute for Work & Health research.
By 2009, Ontario's Workplace Safety and Insurance Board (WSIB) was certainly getting the message that its vocational rehabilitation program for injured workers, called Labour Market Re-entry (LMR), was not working as intended. Although bad press and a value-for-money audit drove the point home, evidence from a research project started two years earlier also indicated problems were afoot.
That research was led by Institute for Work & Health (IWH) Scientist Dr. Ellen MacEachen. Although the results of the research are just now being published, they played an important role in shaping the WSIB's new Work Reintegration Program, introduced in November 2010. The program, which integrates return to work and vocational rehabilitation, addresses many of the problems described by MacEachen's research.
Source : http://www.iwh.on.ca/at-work/67/IWH-research-helps-shape-new-work-integration-initiative
Objectives This study aims to identify the hazard functions that describe the occurrence patterns of new and recurrent sick leave (SL) episodes for mental, respiratory, and musculoskeletal diagnoses.
Methods The data come from a cohort of workers in the Hospital das Clínicas da Universidade Federal de Minas Gerais, Brazil, including all employees working ≥20 hours per week, whose first employment relation with the hospital started between 1 January 2000 and 31 December 2007 (N=1579). We created 15 samples corresponding to combinations of diagnoses causing SL and the number of previous episodes already suffered. We fitted Weibull, log-normal, and log-logistic models by resampling and selected the model having the lowest Akaike information criterion in the greatest number of resamples.
Results Differences were observed in the probability distributions associated with the process generating a SL. Diagnosis showed important differences in terms of risk intensity: mental episodes were the least frequent. There were differences in risk intensity and shape of the function over time depending on the episode number, particularly between the first episode and recurrences. In addition, these differences varied by diagnosis.
Conclusions In most of the samples analyzed, we identified a mixture of distributions, implying a need to revise the statistical methods of analysis for SL occurrence with the aim of obtaining consistent estimates of the risk and the associated factors.
Source : http://www.sjweh.fi/show_abstract.php?abstract_id=3276
Muijzer, Anne et coll. (2012, sous presse). Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study. BMC Public Health, 12. (version provisoire en libre accès)
Background: Efforts undertaken during the return to work (RTW) process need to be sufficient to prevent unnecessary applications for disability benefits. The purpose of this study was to identify factors relevant to RTW Effort Sufficiency (RTW-ES) in cases of sick-listed employees with chronic low back pain (CLBP). Methods: Using focus groups consisting of Labor Experts (LE's) working at the Dutch Social Insurance Institute, arguments and underlying grounds relevant to the assessment of RTW-ES were investigated. Factors were collected and categorized using the International Classification of Functioning, Disability and Health (ICF model). Results: Two focus groups yielded 19 factors, of which 12 are categorized in the ICF model under activities (e.g. functional capacity) and in the personal (e.g. age, tenure) and environmental domain (e.g. employer-employee relationship). The remaining 7 factors are categorized under intervention, job accommodation and measures. Conclusions: This focus group study shows that 19 factors may be relevant to RTW-ES in sick-listed employees with CLBP. Providing these results to professionals assessing RTW-ES might contribute to a more transparent and systematic approach. Considering the importance of the quality of the RTW process, optimizing the RTW-ES assessment is essential.
Source: http://www.biomedcentral.com/1471-2458/12/77/abstract
Spieler, Emily A. et coll. (sous presse). The lack of correspondence between work-related disability and receipt of workers' compensation benefits. American Journal of Industrial Medicine.
Background: Previous studies suggest that many persons with disabilities caused by work do not receive workers' compensation benefits. Methods: Data from surveys of persons with disabilities were used to estimate the proportion of disability due to work-related injuries and diseases. Studies examining the proportion of workers with work-related disability who received workers' compensation benefits were reviewed. Legal and other factors explaining the lack of receipt of workers' compensation benefits were examined. Results: Many workers with disabilities caused by work do not receive workers' compensation benefits. The obstacles to compensation include increasingly restrictive rules for compensability in many state workers' compensation programs. Conclusions : A substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits. The solutions to this problem, such as providing healthcare to workers regardless of the source of injuries or diseases, are complicated and controversial, and will be difficult to implement.
Source: http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1097-0274
Vous voulez connaître les tous derniers résultats de recherche portant sur le lien entre l'augmentation des exigences psychologiques au travail et la dépression; vous voulez en savoir davantage sur l'impact de la recherche sur le développement du nouveau programme ontarien de réadaptation au travail; vous voulez en savoir davantage sur les politiques de la Californie à l'égard des travailleurs ayant une incapacité de longue durée; enfin, vous voulez connaître les nouveaux outils d'aide au retour au travail développés par l'Institute for Work & Health de l'Ontario? Consultez le dernier numéro du bulletin AT WORK, le bulletin trimestriel de l'Institute for Work & Health.
Accessible gratuitement : http://www.iwh.on.ca/at-work
Background Reliable and valid measurement of workplace organizational policies and practices (OPPs) is needed to evaluate their influences on the prevention and management of occupational injuries. Methods Injured workers (n = 614) attending an upper-limb specialty clinic operated by the Workplace Safety & Insurance Board of Ontario were recruited for a 1-year study. The OPP-11, completed at baseline, was examined for scaling properties (floor/ceiling effects, internal consistency, and item-convergent/discriminant validity), construct validity, and factor structure. Predictive validity for longitudinal work disability was examined using multivariable logistic regressions. Results Strong scaling properties were observed for the OPP-11. High internal consistency (Cronbach's alpha = 0.80-0.90) and expected associations with comparator constructs were evident. A 4-domain structure (fit statistics: CFI = 0.98, TLI = 0.97, and RMSEA = 0.06) was supported. Higher OPP-11 predicted more favorable 12-month work disability outcomes, after adjusting for demographic and health attributes. Conclusions The OPP-11 is valid for use in upper-limb disorders. Expanding the ergonomic practices domain could be considered.
Source : Tang K, MacDermid JC, Amick BC, Beaton DE . American Journal of Industrial Medicine, Vol. 54, issue 11, 834 – 846. DOI: 10.1002/ajim.20994
http://www.iwh.on.ca/biblio/the-11-item-workplace-organizational-policies-and-practices-questionnaire-opp-11-examination
10.1002/ajim.20994
Ahola, Kirsi et coll. (2012). Burnout and Behavior-Related Health Risk Factors: Results From the Population-Based Finnish Health 2000 Study. Journal of Occupational & Environmental Medicine, 54(1): 17-22.
Objective: To explore the relationship between burnout and behavior-related health risk factors. Methods: We collected data from a population-based sample (n = 3264) through interviews, questionnaires, and health examinations. Burnout was assessed using the Maslach Burnout Inventory—General Survey. Smoking, alcohol consumption, and leisure-time physical activity were self-reported. Obesity was based on measurements at screening. Results: Burnout and exhaustion were associated with a higher likelihood of risk factors. More specifically, burnout syndrome was related to low physical activity and obesity, exhaustion dimension to low physical activity and heavy drinking, cynicism dimension to low physical activity, and diminished professional efficacy to low physical activity, obesity, and lower likelihood of heavy drinking. Conclusions: Improving working conditions and psychoeducation on recommended ways of coping and recovery could help to prevent negative health consequences of chronic work stress.
Source: http://journals.lww.com/joem/Abstract/2012/01000/Burnout_and_Behavior_Related_Health_Risk_Factors_.7.aspx
Les lésions musculo-squelettiques (LMS) constituaient 37,3 % des maladies professionnelles indemnisées au Québec en 2000, occasionnant ainsi 40,7 % des sommes déboursées, soit près de 170 millions de dollars. Vu la situation, la CSST souhaite obtenir une évaluation scientifique de l'implantation du programme de réadaptation PRÉVICAP, actuellement à l'essai dans quatre régions. Les chercheurs étudieront la capacité de ce programme à répondre aux besoins des travailleurs risquant une incapacité prolongée, comparativement aux approches conventionnelles, ses effets sur les probabilités de retour au travail et ses aspects économiques. L'analyse de son implantation permettra de dégager les facteurs liés à son déroulement satisfaisant : contexte socio-économique, caractéristiques des entreprises et degré de coordination entre les acteurs. Ce projet permettra de mesurer l'efficacité et la rentabilité du PREVICAP, ainsi que de connaître les modifications organisationnelles qui pourraient optimiser la prise en charge des travailleurs victimes d'une LMS visant leur retour rapide et durable au travail. Les conclusions de cette étude fourniront à la CSST des données essentielles pour juger de la pertinence de généraliser la mise en place du programme PREVICAP.
Source : http://www.irsst.qc.ca/-publication-irsst-evaluation-implantation-impact-programme-previcap-r-716.html
The capacity to implement effective strategies in an organization largely depends on the capacity to mobilize on-site stakeholders around a common project. This study aims to identify the practices and paradigms of workplace stakeholders involved in managing and following up on the return to work of employees who have been absent for mental health reasons.
Source : St-Arnaud, L.; Pelletier, M.; Briand, C. Journal for Social Action in Counseling and Psychology, Vol. 3, No 2, Fall 2011
http://www.psysr.org/jsacp/St-Arnaud-v3n2-11_36-52.pdf
Voici une série d'articles portant sur les processus neurosensoriels de la douleur en hommage au pionnier de la recherche dans ce domaine, le Docteur Ronald Melzack, professeur émérite au Département de psychologie de l'Université McGill et à qui nous devons le McGill Pain Questionnaire. Des collaborateurs des cinq continants ont participé à ce numéro spécial.
http://www.neuropain.ch/sites/default/files/e-news/e-news_91.pdf
Le 4 novembre dernier, s'est tenu à l'Institut de réadaptation Gingras-Lindsay-de-Montréal, le Colloque sur la réadaptation au travail: du "Rapport Spitzer" à nos jours - 24 ans plus tard! organisé par l'IRSST en collaboration avec le REPAR. Ce colloque a été un grand succès avec plus de 130 participants à la journée.
Vous pouvez accéder aux présentations et vidéos de la journée en suivant le lien:
http://www.irsst.qc.ca/conferenciers-Spitzer-a-nos-jours-4-novembre-2011.html
Source: REPAR-FRQS
Pilotée par l'Association pour la promotion des professions para-médicales et supervisée par la Haute Autorité de santé, cette source d'information poursuit trois objectifs : 1) valoriser les écrits francophones en physiothérapie et masso-kinésithérapie; 2) « favoriser l'accès à l'information et 3) améliorer l'état des connaissances et de la recherche ». Ouvrages, périodiques, recommandations, mémoires et thèses, activités prfessionnelles et textes officiels forment le contenu de la base de données à partir de laquelle nombre de textes intégraux peuvent être consultés. Un guide d'utilisation ainsi qu'une liste de sources et de liens complètent l'outil.
Source :
http://kinedoc.org/Kinedoc-war/pageAccueil.do
Coutu, MF; Baril, R; Durand, MJ; Côté, D; Cadieux, G. (2011). Health and illness representations of workers with a musculoskeletal disorder-related work disability during work rehabilitation: a qualitative study. Journal of Occupational Rehabilitation, 21(4):591-600.
Introduction Distinctions between disease and illness have been criticized for being too theoretical. In practice, however, it may help explain gaps in understanding and miscommunication between health care professionals and patients/injured workers, since each has their own perception of reality. To reduce the gap between health care professionals and patients in understanding the definition of disease, this paper documents general representations of health, illness and work-related musculoskeletal disorders and their influence on the work rehabilitation program.
Methods A qualitative methodology was used. Semi-structured interviews were conducted with 16 participants (male, female) recruited when they were starting an intensive interdisciplinary work rehabilitation program for chronic pain due to a musculoskeletal disorder. Interviews were performed at three points during the program and 1 month after discharge.
Results First, participants described health and illness in terms of: (1) illness prototype; (2) the absence or presence of symptoms; (3) physical health and capacities; (4) engaging in a healthy lifestyle; (5) maintaining independence; (6) preserving mental well-being; and (7) healing from accidents or injuries. A second observation was that rehabilitation success depended on workers transitioning from a less mechanistic to a more functional view of health.
Conclusion This study highlights the importance of identifying and acknowledging workers' health, illness and WRMSD representations to facilitate their return to work.
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