2013-09-01 12:00 - Messages

A Theoretical Model of Co-worker Responses to Work Reintegration Processes

Purpose Emerging research has shown that co-workers have a significant influence on the return-to-work outcomes of partially fit ill or injured employees. By drawing on theoretical findings from the human resource and wider behavioral sciences literatures, our goal was to formulate a theoretical model of the influences on and outcomes of co-worker responses within work reintegration. Methods From a search of 15 data bases covering the social sciences, business and medicine, we identified articles containing models of the factors that influence co-workers' responses to disability accommodations; and, the nature and impact of co-workers' behaviors on employee outcomes. To meet our goal, we combined identified models to form a comprehensive model of the relevant factors and relationships. Internal consistency and externally validity were assessed. Results The combined model illustrates four key findings: (1) co-workers' behaviors towards an accommodated employee are influenced by attributes of that employee, the illness or injury, the co-worker themselves, and the work environment; (2) the influences–behaviour relationship is mediated by perceptions of the fairness of the accommodation; (3) co-workers' behaviors affect all work reintegration outcomes; and (4) co-workers' behaviours can vary from support to antagonism and are moderated by type of support required, the social intensity of the job, and the level of antagonism. Conclusions Theoretical models from the wider literature are useful for understanding the impact of co-workers on the work reintegration process. To achieve optimal outcomes, co-workers need to perceive the arrangements as fair. Perceptions of fairness might be supported by co-workers' collaborative engagement in the planning, monitoring and review of work reintegration activities.

Source : Debra A. Dunstan, Ellen Maceachen . Journal of Occupational Rehabilitation, August 2013. http://dx.doi.org/10.1007/s10926-013-9461-x

Factors associated with generalized anxiety in workers undergoing work rehabilitation for persistent musculoskeletal pain

Purpose: To document in workers having a work disability due to a musculoskeletal disorder (MSD), the presence and variation over time of their intolerance of uncertainty and its maintenance factors as defined in Dugas et al.’s generalized anxiety disorder (GAD) model, i.e. worries, negative problem orientation, beliefs about the usefulness of worrying, cognitive avoidance and their consequences on depressive symptoms. Methods: An observational, prospective repeated-measures design was retained. Thirty-nine workers with an MSD having caused a work absence of over three months and who were beginning a work rehabilitation program were recruited and evaluated at four moments (beginning of rehabilitation program, first hours of work exposure, 50% of regular working hours and end of rehabilitation program). Validated self-report questionnaires measuring intolerance of uncertainty and its maintenance factors were administered. Finally, the Worry and Anxiety Questionnaire measured the presence and intensity of GAD symptoms as defined in the DSM-IV-TR. Results: Fifty percent of the workers initially exhibited GAD symptoms. Concerning the variation over time, improvements were noted in all GAD-related factors during the program, particularly with the first hours of work exposure. At the end of rehabilitation, only 21% of the participants still met GAD diagnostic criteria. Conclusion: Workers with an MSD causing a work disability averaging one year in length and enrolled in a work rehabilitation program exhibited a high level of anxiety at the beginning of the work rehabilitation program. Workers perceived a usefulness in worrying and presented some intolerance of uncertainty and some cognitive avoidance strategies. According to Dugas et al.’s GAD model, the intensity of the symptoms associated with GAD development and maintenance factors was, however, not typical of a GAD. A reconceptualization of the problem in terms of reducing the work disability rather than reducing pain may constitute a promising avenue to reduce anxiety symptoms. Future studies should look at the specific impact of work exposure, not only on pain symptoms but also on worries.

Source : Coutu, Marie-France; Durand, Marie-José; Marchand, André; Labrecque, Marie-Elise; Berbiche, Djamal; Cadieux, Geneviève. Disability and Rehabilitation, Vol. 35, no 19, September 2013 , p. 1599-1607. http://dx.doi.org/10.3109/09638288.2012.748833


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