2016-09-01 12:00 - Messages

Ill Health–Related Job Loss

A One-Year Follow-Up of 54 026 Employees
Introduction: The diagnoses of workers being unfit to work may be a relevant health indicator. Therefore, the aim of this study was to analyze the one-year incidence of an unfit to work diagnosis.
Method: This one-year prospective study included all workers undergoing annual work medical examination from occupational health services in Troyes, France.
Results: Twenty-one occupational physicians followed 54,026 employees. The all-cause incidence of being unfit to return to work was 0.772%. The two main causes of being unfit to work were musculoskeletal disorders (61%) and psychopathologies (24%). The relative risk (RR) of being unfit to work, independent of the cause, was higher when employees were aged over 50 years (RR?=?2.51), and female (RR?=?1.51).
Conclusions: Prospective results from occupational physicians' medical records may provide significant and cost-effective directions to prioritize actions and target health promotion in the workplace.

Source: Dutheil, Frédéric; Naughton, Geraldine; Sindyga, Patricia; Lesage, François-Xavier. Journal of Occupational & Environmental Medicine: September 2016, volume 58, Issue 9, p. 918-923.

Measurement Properties of the Quebec Back Pain Disability Scale in Patients With Nonspecific Low Back Pain

Systematic Review
Background: The Quebec Back Pain Disability Scale (QBPDS) has been translated into different languages, and several studies on its measurement properties have been done.
Purpose: The purpose of this review was to critically appraise and compare the measurement properties, when possible, of all language versions of the QBPDS by systematically reviewing the methodological quality and results of the available studies.
Method: Bibliographic databases (PubMed, Embase, CINAHL, and PsycINFO) were searched for articles with the key words “Quebec,” “back,” “pain,” and “disability” in combination with a methodological search filter for finding studies on measurement properties concerning the development or evaluation of the measurement properties of the QBPDS in patients with nonspecific low back pain. Assessment of the methodological quality was carried out by the reviewers using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for both the original language version of the QBPDS in English and French and all translated versions. The results of the measurement properties were rated based on criteria proposed by Terwee et al.
Results: The search strategy resulted in identification of 1,436 publications, and 27 articles were included in the systematic review. There was limited-to-moderate evidence of good reliability, validity, and responsiveness of the QBPDS for the different language versions, but for no language version was evidence available for all measurement properties.
Conclusion: For research and clinical practice, caution is advised when using the QBPDS to measure disability in patients with nonspecific low back pain. Strong evidence is lacking on all measurement properties for each language version of the QBPDS.

Source: Speksnijder, C. M., Koppenaal, T., Knottnerus, J. A., Spigt, M., Staal, J. B., & Terwee, C. B. (2016). Physical Therapy, 2016. http://dx.doi.org/10.2522/ptj.20140478.

Web-Based Interventions for Chronic Back Pain: A Systematic Review

Background: Chronic low back pain is one of the most common presenting complaints to a physician's office. Treatment is often challenging and recovery depends on various factors, often resulting in significant investments of time and resources.
Objective: The aim of this review is to determine which Web-based interventions aimed at chronic low back pain are of benefit to patients.
Methods: Randomized controlled trials (RCTs) studying Web-based interventions directed at adults with chronic low back pain were included. Retrospective studies, narrative reviews, nonrandomized trials, and observational studies were excluded. Electronic databases and bibliographies were searched.
Results: In total, nine unique RCTs were identified (total participants=1796). The number of patients randomized in each trial ranged from 51 to 580. Four trials studied online cognitive behavioral therapy (CBT) and five trials studied other Web-based interventions with interactive features. Empowerment/control was improved in six studies. Use of CBT was associated with reduced catastrophization among patients. Mixed results were reported with regards to reduction in pain levels and disability, although some studies showed promise in reducing disability in the short term. One study that measured health care utilization reported reduced utilization with the use of moderated email discussion.
Conclusions: Limited data are available regarding effective Web-based interventions to improve outcomes for patients with chronic low back pain. Nine RCTs with small sample sizes were identified in this review. Online CBT appears to show some promise in terms of reducing catastrophization and improving patient attitudes. Further research in this area with larger-scale studies focusing on appropriate outcomes appears to be a priority.

Source: Shashank Garg, Divya Garg, Tanvir C Turin, M Faruq U Chowdhury. J Med Internet Res, 2016; 18 (7), p. e139.

Factors associated with return to work in men and women with work-related traumatic brain injury

Background: Symptoms that persist subsequent to a work-related traumatic brain injury (wrTBI) influence the ability to return to work (RTW) and indicate areas of functional disability, as classified in the International Classification of Functioning, Disability and Health (ICF) framework.
Objective: The purpose of this study was to describe the relationship between RTW status and ICF framework domains in men and women with a wrTBI.
Methods: A retrospective chart review of 209 consecutive workers with TBI (mild TBI: 71.8%; mean age: 40.2 ± 11.1, men: 71.3%) was conducted. Workers were assessed during the chronic post-injury phase, at the neurology service of a large rehabilitation hospital in Ontario, Canada in 2003. Frequency distributions were calculated and chi-square tests performed.
Results: At the point of assessment, 78.0% of workers were in receipt of disability benefits, while the remainder had returned to work on a full- or part-time basis. Significant differences were observed in the Body Functions and Structures domain of the ICF model, specifically clinical diagnoses of depression, anxiety, pain disorders; self-perceived cognitive disturbance, and certain psychosocial factors (p < 0.05), between workers who had returned to work and those who had not. When stratified according to sex, these associations remained significant only in men.
Conclusions: The factors outlined above should be subject to further TBI research, as indicators for RTW. The lack of significant findings in women warrants further exploration of variables within the physical and social environmental domains of the ICF.

Source: Chen Xiong, Tickalyn Martin, Aneesha Sravanapudi, Angela Colantonio, Tatyana Mollayeva. Disability and Health Journal, Volume 9, Issue 3, July 2016, p. 439-448.

Effectiveness of a return-to-work program for workers without an employment contract, sick-listed due to common mental disorders

A participatory supportive return-to-work (RTW) program did not result in a significant shorter duration until sustainable RTW of workers without an employment contract, sick-listed due to a common mental disorder, compared to usual occupational healthcare. Further research is needed to consider how vocational needs of these vulnerable workers could be better addressed.

Source: Lammerts L, Schaafsma FG, Bonefaas-Groenewoud K, van Mechelen W, Anema JR. Scand J Work Environ Health, 2016.

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