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Implementation of the Danish return-to-work program
Process evaluation of a trial in 21 Danish municipalities Objectives: The aim of this study was to evaluate the implementation of the Danish national return-to-work (RTW) program in 21 Danish municipalities. Methods: We conducted a structured process evaluation on (i) reach and recruitment, (ii) fidelity, (iii) dose-delivered, (iv) dose-received, and (v) context by formulating 29 implementation criteria and analyzing qualitative and quantitative data from administrative records, interviews, field notes, and questionnaires. Results: All municipalities integrated the basic features of the RTW program...
Effect of the Danish return-to-work program on long-term sickness absence
Results from a randomized controlled trial in three municipalities Objectives : The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities. Methods : The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary...
Maladies chroniques et travail : l'exemple danois du programme "Return To Work"
Les maladies chroniques évolutives posent un challenge majeur en matière de santé en Europe. Mais elles ont aussi un impact substantiel sur le marché du travail et la vie professionnelle. Des actions sur l’organisation du travail peuvent pourtant être menées pour améliorer la situation des salariés et celle des entreprises. Le réseau Anact est l'opérateur pour la France d'un projet réunissant 18 pays de l'Union sur ce sujet. Retour d'expérience sur une initiative danoise. Dans un contexte de...
Maladies chroniques et travail : l'exemple danois du programme "Return To Work"
Les maladies chroniques évolutives posent un challenge majeur en matière de santé en Europe. Mais elles ont aussi un impact substantiel sur le marché du travail et la vie professionnelle. Des actions sur l’organisation du travail peuvent pourtant être menées pour améliorer la situation des salariés et celle des entreprises. Le réseau Anact est l'opérateur pour la France d'un projet réunissant 18 pays de l'Union sur ce sujet. Retour d'expérience sur une initiative danoise Source : http://www...
The Danish national return-to-work program: aims, content, and design of the process and effect evaluation
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...
Comparison of Chronic Occupational Upper Extremity Versus Lumbar Disorders for Differential Disability-Related Outcomes and Predictor Variables
Objective: To systematically evaluate if an interdisciplinary functional restoration program (FRP), shown to be a viable treatment option for patients with chronic disabling occupational lumbar disorders, is as effective in treating chronic disabling occupational upper extremity disorders. Methods: Participants were 2484 consecutive patients with either arm or lumbar disorders admitted to an FRP. Analyses compared demographic, psychosocial, and work-related factors, and 1-year post-rehabilitation socioeconomic outcomes. Results: Socioeconomic outcomes showed that work-return and work-retention...
Évaluation de l’implantation et de l’impact du programme PRÉVICAP
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...
Effect of a multidisciplinary stress treatment programme on the return to work rate for persons with work-related stress. A non-randomized controlled study from a stress clinic
(Article disponible en libre accès) In recent years an increasing number of patients have been referred to the medical sector with stress symptoms. Moreover, these conditions imply increased sickness absence. This indicates a need for treatment programmes in general medical practice. The aim of this study was to test the effect of a multidisciplinary stress treatment programme on the return to work (RTW) rate in persons with work-related stress and establish predictive factors for this outcome. Methods: During a two-year period 63 out of 73 referrals to the Stress Clinic (a section of a...
Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non-specific low back pain: randomised controlled trial
INTRODUCTION: In recent decades the treatment of non-specific low back pain has turned to active modalities, some of which were based on cognitive-behavioural principles. Non-randomised studies clearly favour functional multidisciplinary rehabilitation over outpatient physiotherapy. However, systematic reviews and meta-analysis provide contradictory evidence regarding the effects on return to work and functional status. The aim of the present randomised study was to compare long-term functional and work status after 3-week functional multidisciplinary rehabilitation or 18 supervised outpatient...
What Concerns Workers with Low Back Pain? Findings of a Qualitative Study of Patients Referred for Rehabilitation
Health and workplace strategies to address work loss and sickness absence due to low back pain are urgently required. A better understanding of the experiences of those struggling to stay at work with back pain may help clinicians and employers with their treatment and management approaches. Methods A qualitative approach using thematic analysis was used. Individual semi-structured interviews were conducted with a convenience sample of 25 low back pain patients who had been referred for multidisciplinary back pain rehabilitation. All were in employment and concerned about their ability to work...
A bio-psycho-social exercise program (RUCKGEWINN) for chronic low back pain in rehabilitation aftercare - Study protocol for a randomised controlled trial
There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours). Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality...
A multidisciplinary rehabilitation programme for patients with chronic low back pain: a prospective study
PURPOSE. To examine the effectiveness of a multidisciplinary rehabilitation programme for patients with chronic low back pain in Hong Kong, and to identify factors associated with work resumption. METHODS. 57 men and 8 women aged 20 to 56 (mean, 39) years who had a more than 3-month history of low back pain and were unresponsive to more than 6 months of conventional treatment participated in a 14-week multidisciplinary rehabilitation programme involving physical conditioning, work conditioning, and work readiness. Training protocols entailed flexibility and endurance training, hydrotherapy, weight...
What Concerns Workers with Low Back Pain? Findings of a Qualitative Study of Patients Referred for Rehabilitation
Health and workplace strategies to address work loss and sickness absence due to low back pain are urgently required. A better understanding of the experiences of those struggling to stay at work with back pain may help clinicians and employers with their treatment and management approaches. Methods A qualitative approach using thematic analysis was used. Individual semi-structured interviews were conducted with a convenience sample of 25 low back pain patients who had been referred for multidisciplinary back pain rehabilitation. All were in employment and concerned about their ability to work...
A systematic review of multidisciplinary outcomes in the management of chronic low back pain
Objective: Previous research has provided an inconsistent message as to the effectiveness of multidisciplinary programs to improve employment outcomes in clients with Chronic Low Back Pain (CLBP). The primary aims of this review were to: 1) update the evidence for the multidisciplinary treatment of CLBP to improve employment outcomes 2) assess what knowledge supports occupational therapy as contributing to a multidisciplinary approach in the treatment of CLBP. Participants: Working-age adults experiencing CLBP who took part in controlled trials evaluating multidisciplinary programs between July...
British pain clinic practitioners' recognition and use of the bio-psychosocial pain management model for patients when physical interventions are ineffective or inappropriate: results of a qualitative study
Background : To explore how chronic musculoskeletal pain is managed in multidisciplinary pain clinics for patients for whom physical interventions are inappropriate or ineffective. Methods: A qualitative study was undertaken using semi-structured interviews with twenty five members of the pain management team drawn from seven pain clinics and one pain management unit located across the UK. Results : All clinics reported using a multidisciplinary bio-psychosocial model. However the chronic pain management strategy actually focussed on psychological approaches in preference to physical approaches...
Controlled 3-year follow-up of a multidisciplinary pain rehabilitation program in primary health care
Purpose . The high prevalence of musculoskeletal pain generates significant costs for primary health care and the whole of society. The development of appropriate interventions is therefore necessary. The aim of this effectiveness study was to assess the long-term effects of a primary health care multidisciplinary rehabilitation program in Sweden. Methods . An experimental group comprising 89 patients from two primary health care units received individualised treatment interventions after a multidisciplinary investigation. A control group of 69 patients with the same inclusion criteria from four...
Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach
Despite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive. Recent research suggests that interventions that are focused at the workplace and incorporate the principals of participatory ergonomics and return-to-work (RTW) coordination can improve RTW and reduce disability following a work-related back injury. Workplace interventions or programs to improve RTW are difficult to design and implement given the various individuals and environments involved, each with their own unique circumstances. Intervention mapping provides a framework...
What factors predict full or partial return to work among sickness absentees with spinal pain participating in rehabilitation?
Purpose. To identify the factors that predict full or partial return to work among long-term (>/=90 days) sickness absentees due to spinal pain who begin a multidisciplinary rehabilitation programme. Method. In a prospective cohort study, 312 patients with neck, thoracic and/or lumbar pain, aged 20-64, participated in a 4-week multidisciplinary rehabilitation programme in Sweden. Questionnaire data at inclusion were used. Factors included in logistic regressions were as follows: age, gender, type of work, pain location, pain intensity (visual analogue scale), activity limitations [Disability...

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