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Relations interculturelles - Comprendre le processus de réadaptation et de retour au travail
Dans le domaine de la santé et de la sécurité du travail (SST), les barrières linguistiques et culturelles sont souvent décrites comme des facteurs de vulnérabilité des travailleurs. Il est rapporté que de telles barrières ont déjà été ou sont encore à l'origine d'erreurs diagnostiques ou de mauvaises évaluations cliniques, compliquant ainsi le processus de réadaptation et de retour au travail. La problématique de la réadaptation et du retour au travail dans le contexte...
Facteurs prédictifs d'une restriction d'aptitude ou d'une inaptitude au poste de travail antérieur en visite de reprise
Élaboration d'un score L'objectif est d'étudier les facteurs liés à la décision d'aptitude du médecin du travail lors de la visite de reprise d'un salarié après un arrêt de travail pour maladie. Une enquête descriptive multicentrique transversale a été réalisée auprès de 402 salariés suivis par des services de santé au travail (SST) de l'agglomération stéphanoise. La reprise du travail au poste antérieur est significativement liée...
Disability Employment Services in Australia: A Brief Primer
This review aims to highlight how the chronic condition self-management support (CCSMS) field might inform and enhance the skills of the disability employment services (DES) workforce, particularly in its interactions with clients with complex disability needs. The approach we have taken involves a consideration of current education and training, recruitment of staff into DES and issues of concern arising from these processes. The main findings of our review are that the current DES workforce may not have the required skills to fully meet the needs of the populations they serve given the growing...
Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?
Objective: To assess the relationships between patient experiences and two overall evaluations – satisfaction and service quality – in outpatient rehabilitation settings. Design : A cross-sectional, self-reported survey carried out in the year 2009. Setting: Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville. Subjects : Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. Main measures : Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction...
Work-related injuries in Canadian occupational therapy practice
BACKGROUND : No studies investigate work-related injuries experienced by Canadian occupational therapists. PURPOSE : To identify the nature and prevalence of work-related injuries, impact of practice context, cultural and structural factors that influence response to these injuries, and strategies used to manage return-to-work after injury. METHODS : Members of the Canadian Association of Occupational Therapists were sent an electronic survey in June 2009. FINDINGS: Over half of the 600 respondents reported at least one injury episode. Patient-handling and equipment-related incidents accounted...
Intercultural communication in health care: challenges and solutions in work rehabilitation practices and training: a comprehensive review
Côté, Daniel (2012). Intercultural communication in health care: challenges and solutions in work rehabilitation practices and training: a comprehensive review. Disability & Rehabilitation (sous presse, disponible en ligne) Purpose: The purpose of this comprehensive literature review it to explore cross-cultural issues in occupational rehabilitation and work disability prevention. Method: A literature review on cross-cultural issues was performed in medicine, health sciences, and social sciences databases (PubMed, Ingenta, Canadian Centre for Occupational Health and Safety, Ergonomics...
Factors affecting RTW following acute low-back pain
Steenstra, Ivan et coll. (2012). Factors affecting RTW following acute low-back pain. Institute for Work & Health (IWH) Sommaire d'une recension des écrits sur les déterminants du retour au travail chez les personnes souffrant de lombalgies aigues. Although most workers with acute low-back pain (i.e. pain for up to six weeks) return to work following a relatively straightforward path, anywhere from one-fifth to one-third go on to suffer chronic low-back pain (i.e. pain for longer than three months). This results in potentially lengthy absences from work. This systematic review...
Medical Interpretation for Immigrant Workers
Forst, Linda et coll. (2012). Medical Interpretation for Immigrant Workers. New Solutions: A Journal of Environment and Occupational Health Policy , 22(1): 37-50. Foreign-born workers have high rates of occupational mortality and morbidity, despite downward trends for the U.S. workforce overall. They have limited access to health care services. Medical interpreters (MIs) facilitate care of acutely injured, low-English-proficiency (LEP) patients, including those sustaining occupational injuries. Our goal was to assess the potential for MIs to serve as advocates of LEP patients injured at work and...
Communication style: help or hindrance in facilitating return to work?
Williams (2011). Communication style: help or hindrance in facilitating return to work? Occupational Medicine , 61 (6): 380-382. (Éditorial) Extraits: Bandura's theory states that ‘Perceived self-efficacy refers to beliefs in one's capabilities to organise and execute the courses of action required to produce given attainments. It is a useful concept that has attracted significant attention with regard to unemployed people but its application to return from sick leave has been little researched (...) It is known that the longer people who have chronic health problems are absent...
Swedish rehabilitation professionals' perspectives on work ability assessments in a changing sickness insurance system
Stååhl, Christian et al. (2011). Swedish rehabilitation professionals' perspectives on work ability assessments in a changing sickness insurance system. Disability & Rehabilitation , 33 (15-16): 1373-1382. Purpose . Changes in the Swedish sickness insurance system shifts focus from return-to-work to labour market reintegration. This article analyses Swedish rehabilitation professionals' perspectives on how the changed regulations affect practice, with a special focus on work ability assessments. Methods . Two groups of representatives (( n == 15)) from organizations...
A Typology of Sick-Listed Claimants to Improve Communication Skills for Social Insurance Physicians during Medical Disability Assessment Interviews
Van Rijssen, H. J. et al. (2011). A Typology of Sick-Listed Claimants to Improve Communication Skills for Social Insurance Physicians during Medical Disability Assessment Interviews. Journal of Occupational Rehabilitation, 21 (1): 66-75. Introduction Role play with standardised simulated patients is often included in communication training. However, regarding physician-patient encounters in medical disability assessment interviews it is unclear what should be included in the scenarios for actors. The first objective of this study was to determine which types of medical disability claimants can...
Cultural competence in occupational therapists working in early intervention therapy programs
Eleanor L. Wray et Patricia A. Mortenson (2011). Cultural competence in occupational therapists working in early intervention therapy programs. Canadian Journal of Occupational Therapy , 78(3): Description. La compétence culturelle favorise l’atteinte de résultats équitables en matière de soins de santé et permet de veiller à ce que les ergothérapeutes aident leurs clients à réaliser des activités quotidiennes adaptées à leur culture. Toutefois, on ne sait pas vraiment dans quelle mesure les ergothérapeutes...
Sick-listed employees with severe medically unexplained physical symptoms: burden or routine for the occupational health physician? A cross sectional study
Hoedeman, Rob et al. (2010). Sick-listed employees with severe medically unexplained physical symptoms: burden or routine for the occupational health physician? A cross sectional study. BioMedCentral, 10 (305) (article en libre accès) The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS). Third objective was to determine which disease-, patient-, doctor- and practice...
The meaning of the experiences of persons with chronic pain in their encounters with the health service
Chronic pain causes great suffering for those affected and treating it is one of the most common assignments in the health service. The aim of the study was to investigate the meaning of the experiences of persons with chronic pain in their encounters with health service staff. The study had a descriptive design with a phenomenological approach based on the perspective of caring science. Interviews were carried out with eight patients. The study showed that patients experienced a positive approach and that the staff had understood the serious nature of the situation. A positive approach can communicate...
Community occupational therapists' clinical reasoning: Identifying tacit knowledge
Occupational therapy interventions in the community, a fast expanding practice setting, are central to an important social priority, the ability to live at home. These interventions generally involve only a small number of home visits, which aim at maximising the safety and autonomy of community-dwelling clients. Knowing how community occupational therapists determine their interventions, i.e. their clinical reasoning, can improve intervention efficacy. However, occupational therapists are often uninformed about and neglect the importance of clinical reasoning, which could underoptimise their interventions...
Language difficulties in outpatients and their impact on a chronic pain unit in Northwest Switzerland
Many foreign patients attending our pain clinic are unable to understand one of the four Swiss national languages and are also unable to speak English. Therefore, communication with these patients can be very difficult or even impossible. Consequently, diagnosis and treatment may also prove difficult. Recognizing that language barriers can have deleterious effects, the use of an interpreter is at times the only way to communicate, however, the financial responsibility becomes that of the health care provider. Many foreign patients attending our pain clinic are unable to understand one of the four...
Work ability – experiences and perceptions among physicians
Purpose .To describe experiences and perceptions of work ability and how it can be assessed among Swedish physicians. Method .We interviewed eight men and six women in the fields of general practice, occupational health, rehabilitation and orthopaedic surgery. Qualitative content analysis was applied to the data. Results .The approach striving to support the patient in mutual confidence was what primarily affected how work ability was understood and how it could be assessed. Two main categories, with sub categories were settled: familiar but vague, with subcategories conflicting expectations and...
A Typology of Sick-Listed Claimants to Improve Communication Skills for Social Insurance Physicians during Medical Disability Assessment Interviews
Introduction Role play with standardised simulated patients is often included in communication training. However, regarding physician-patient encounters in medical disability assessment interviews it is unclear what should be included in the scenarios for actors. The first objective of this study was to determine which types of medical disability claimants can be distinguished based on behavioural determinants. The second objective was to determine if these types of claimants differed in their perception of communication behaviour and their satisfaction with the communication with physicians. Methods...
Reasons of drop-out from rehabilitation in patients of Turkish and Moroccan origin with chronic low back pain in The Netherlands: A qualitative study
Objective: To explore which factors led to drop-out in patients of Turkish and Moroccan origin with chronic non-specific low back pain who participated in a rehabilitation programme. Subjects: Patients of Turkish or Moroccan origin with chronic non-specific low back pain (n = 23) from 2 rehabilitation centres and 4 rehabilitation departments of general hospitals in the Netherlands. Methods: In-depth semi-structured interviews were conducted with patients of Turkish and Moroccan origin (n = 23), rehabilitation physicians (n = 8) and rehabilitation therapists...
Trust and vulnerability in doctor–patient relations in occupational health
Background The effectiveness of health care intervention depends heavily on the extent to which people trust the health care professionals with whom they come into contact. Therefore, to ensure effective health care, it is important to establish what factors influence patient perceptions of the trustworthiness of health care professionals. Aims To explore the relation between trust and vulnerability in the occupational doctor–patient relationship by considering two opposing hypotheses on factors influencing perceptions of trustworthiness. Methods An explorative, cross-sectional study design...
Therapeutic Engagement: A Proposed Model of Engagement in Medical Rehabilitation
A major goal of physical medicine and rehabilitation is the recovery of function after an injury or the underlying medical condition that has caused impairment in one's daily functioning. The rehabilitation process involves a complex interplay of many factors that influence how well a person benefits from medical rehabilitation. There is burgeoning evidence that for patients to maximize rehabilitation benefits, they must be actively involved or engaged in the process. In this article, the construct of therapeutic engagement is defined, and a theoretical model is proposed to illustrate how and...
Communication as negotiation processes in long-term physiotherapy: a qualitative study
Purpose: The purpose of this study was to describe communicative patterns about change in demanding physiotherapy treatment situations. Methods: A multiple case study of eleven treatment courses was carried out, based on in-depth individual interviews, focus group interview, personal notes and repeated video-recordings. To compare communication within and over sessions, a two-step procedure was applied: identification of communication patterns and detailed analysis of selected dialogues from video-recorded sequences. Findings: One main communicative pattern was identified: Seeking for common ground...
The integration of bio-medicine and culturally based alternative medicine: implications for health care providers and patients
Complementary and alternative medicine (CAM) are therapies used along with or in place of bio-medicine. Many forms of CAM originate in culture, referred to as culturally based alternative medicines. Usage of CAM is high with large numbers of patients using CAM for mental health, pain and musculoskeletal problems. Their desire for holistic care may be the impetus for this interest, as alternative care practitioners spend more time analyzing illness symptoms. These factors along with the global migration of immigrants accustomed to traditional medicine but now immersed in biomedical health care systems...
Young adults' experience of stroke: a qualitative review of the literature
Stroke is a life-threatening event that has a devastating impact on young adults and their families. The author conducted a systematic review of the qualitative literature to explore the experience of stroke from the perspective of young adults. Four primary research 'papers' were analyzed using the Qualitative Assessment and Review Instrument; 60 findings were extracted from the papers and merged into 13 categories, from which three synthesized findings were developed - disorientation, disrupted sense of self, and roles and relationships. Many of the effects of stroke are 'invisible'...
A quantitative approach to measure occupational therapist–client interactions: a pilot study
Aims: The purpose of this pilot study was to assess the feasibility of a quantitative approach to study occupational therapist–client interactions. Role plays were videotaped in which 10 therapists met three client-actors. A questionnaire assessed the occupational therapists' and the patient-actors' opinion of the role-play experience. A modified version of the Roter Interaction Analysis System (RIAS), OT-RIAS, was used to analyse data. Major findings: Occupational therapists considered the role play experience to be “highly realistic” (mean score 5.4 on a 1–6 Likert...
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