scholarly journals ‘Return to Work’ Coordinator Model and Work Participation of Employees: A Natural Intervention Study in Finland

2021 ◽  
Author(s):  
Johanna Kausto ◽  
Tuula Oksanen ◽  
Aki Koskinen ◽  
Jaana Pentti ◽  
Pauliina Mattila-Holappa ◽  
...  
Keyword(s):  
Return To Work ◽  
Sickness Absence ◽  
Work Ability ◽  
Intervention Study ◽  
Total Population ◽  
Relative Increase ◽  
Intervention Period ◽  
Post Intervention ◽  
Disability Retirement

AbstractPurpose Employers increasingly use ‘return to work’ (RTW) coordinators to support work ability and extend working careers, particularly among employees with reduced work ability. We examined whether applying this model was associated with changes in employee sickness absence and disability retirements. Methods We used data from the Finnish Public Sector study from 2009 until 2015. Employees where the model was introduced in 2012 constituted the cases (n = 4120, one municipality) and employees where the model was not in use during the follow-up, represented the controls (n = 5600, two municipalities). We analysed risk of disability retirement in 2013–2015 and risk of sickness absence after (2013–2015) vs. before (2009–2011) intervention by case–control status. Results The incidence of disability retirement after the intervention was lower in cases compared to controls both in the total population (hazard ratio HR = 0.49, 95% CI 0.30–0.79) and in the subgroup of participants with reduced work ability (HR = 0.34, 95% CI 0.12–0.99). The risk of sickness absence increased from pre-intervention to post-intervention period both among cases and controls although the relative increase was greater among cases (RRpost- vs. pre-intervention = 1.26, 95% CI 1.14–1.40) than controls (RRpost- vs. pre-intervention = 1.03, 95% CI 0.97–1.08). In the group of employees with reduced work ability, no difference in sickness absence trends between cases and controls was observed. Conclusions These findings suggest that RTW-coordinator model may increase employee sickness absence, but decrease the risk of disability retirement, i.e., permanent exclusion from the labour market.

scholarly journals Sustained return to work and work participation after a new legislation obligating employers to notify prolonged sickness absence

2018 ◽  
Vol 46 (19_suppl) ◽  
pp. 65-73 ◽  
Author(s):  
Jaana I Halonen ◽  
Svetlana Solovieva ◽  
Lauri J Virta ◽  
Mikko Laaksonen ◽  
Kari-Pekka Martimo ◽  
...  
Keyword(s):  
Return To Work ◽  
Sickness Absence ◽  
Total Sample ◽  
Work Participation ◽  
Occupational Health Services ◽  
Intervention Period ◽  
Post Intervention ◽  
Relative Gain ◽  
Legislative Change ◽  
The Individual

Aims: Return to work (RTW) after prolonged sickness absence benefits both the individual and society. However, the effectiveness of legislation aiming to improve RTW remains uncertain. We examined whether sustained RTW and work participation were different before and after a legislative change enacted in 2012 (i.e. an intervention) that obligated employers to give notice of prolonged sickness absence to occupational health services. Methods: Two random samples (2010 and 2013) of the Finnish working aged population (70%, ~2.6 million each) were drawn. Using survival analysis, we assessed sustained RTW (≥28 consecutive working days) during a two-month follow-up after a sickness absence minimum of 30 calendar days in the pre- and post-intervention period. We also identified pathways for RTW with cluster analysis and calculated relative gain in work participation in the total sample and by several population subgroups. Results: In the total sample, sustained RTW was 4% higher and the mean time to sustained RTW was 0.42 days shorter in the post- than in the pre-intervention period. The estimates were larger among women than men and among those with mental disorders compared with other diagnoses. Changes in the pathways for sustained RTW indicated a 4.9% relative gain in work participation in the total sample. The gain was larger among those who lived in areas of low unemployment rate (20.6%) or worked in the public sector (11.9%). Conclusions: From 2010 to 2013, RTW and work participation increased among the employees with prolonged sickness absence, suggesting that the legislative change enhanced RTW. The change in work participation varied by population subgroup.

scholarly journals 986. Improvement in Administration of HIV Post-Exposure Prophylaxis in the Emergency Department Following Sexual Assault

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Hiv Transmission ◽  
Post Exposure Prophylaxis ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Exposure ◽  
Assault Victims ◽  
Exposure Prophylaxis

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P< 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P< 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P< 0.001), pregnancy (39.0% vs 79.6%; P< 0.001), syphilis (3.4% vs 89.8%; P< 0.001), hepatitis B (15.3% vs 95.5%; P< 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)

scholarly journals Does seeing a psychologist reduce sickness absence due to mental disorders? A quasi-experiment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Lahti ◽  
J Harkko ◽  
H Sumanen ◽  
K Piha ◽  
O Pietiläinen ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Sickness Absence ◽  
Work Ability ◽  
Early Stage ◽  
Matched Sample ◽  
Full Sample ◽  
Common Support ◽  
The City ◽  
Quasi Experiment

Abstract Background Mental ill-health in young adults is a major public health and work-life problem. We examined in a quasi-experimental design whether occupational psychologist appointment can reduce subsequent sickness absence due to mental disorders among young Finnish employees. Methods The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We used Wald test to compare the differences in sickness absence days due to mental disorders (ICD-10, F-diagnosed) between those treated (occupational psychologist appointment for work ability support) and the non-treated (no psychologist appointment) during a one year follow-up. The full sample (n = 2156, 84% women) consisted of employees with mental disorder diagnosed sickness absence during 2009-2014. To account for the systematic differences between the treated and non-treated, the participants were matched according to their characteristics (age, sex, occupational class, education, previous sickness absence and psychotropic medication). The matched sample included 886 participants. We excluded those with treatment before the treatment screening time (± 3 months to the end of sickness absence period), non-treated with treatment during the follow-up and those that could not be matched (lack of common support). Results In the full sample, the mean of sickness absence days due to mental disorders was 17.7 (95% CI, 11.4, 24.1) days for those treated (n = 240) and 23.2 (95% CI, 20.5, 25.9) days for non-treated (n = 1916), difference being non-significant. The corresponding figures in the matched sample were (16.8, 95% CI, 9.5-24.1) for those treated (n = 195) and (27.8, 95% CI, 22.6-32.9) for non-treated (n = 691), difference being statistically significant (p = 0.02). Conclusions This quasi-experiment suggests that seeing an occupational psychologist to support work ability may be reduce mental health related sickness absence. Key messages We showed that supporting work ability at an early stage may prevent sickness absence due to mental disorders. More efforts to provide early stage support for maintaining work ability may prove useful in reducing sickness absence rates in younger employees.

scholarly journals Work ability score and future work ability as predictors of register-based disability pension and long-term sickness absence: A three-year follow-up study

2017 ◽  
Vol 46 (3) ◽  
pp. 321-330 ◽  
Author(s):  
Ulla Kinnunen ◽  
Jouko Nätti
Keyword(s):  
Sickness Absence ◽  
Work Ability ◽  
Disability Pension ◽  
Negative Binomial ◽  
Work Ability Index ◽  
Rate Ratios ◽  
Future Work ◽  
Work Ability Score

Aims: We investigated two single items of the Work Ability Index – work ability score, and future work ability – as predictors of register-based disability pension and long-term sickness absence over a three-year follow-up. Methods: Survey responses of 11,131 Finnish employees were linked to pension and long-term (more than 10 days) sickness absence register data by Statistics Finland. Work ability score was divided into poor (0–5), moderate (6–7) and good/excellent (8–10) and future work ability into poor (1–2) and good (3) work ability at baseline. Cox proportional hazard regressions were used in the analysis of disability pension, and a negative binomial model in the analysis of long-term sickness absence. The results were adjusted for several background, work- and health-related covariates. Results: Compared with those with good/excellent work ability scores, the hazard ratios of disability pension after adjusting for all covariates were 9.84 (95% CI 6.68–14.49) for poor and 2.25 (CI 95% 1.51–3.35) for moderate work ability score. For future work ability, the hazard ratio was 8.19 (95% CI 4.71–14.23) among those with poor future work ability. The incidence rate ratios of accumulated long-term sickness absence days were 3.08 (95% CI 2.19–4.32) and 1.59 (95% CI 1.32–1.92) for poor and moderate work ability scores, and 1.51 (95% CI 0.97–2.36) for poor future work ability. Conclusions: The single items of work ability score and future work ability predicted register-based disability pension equally well, but work ability score was a better predictor of register-based long-term sickness absence days than future work ability in a three-year follow-up. Both items seem to be of use especially when examining the risk of poor work ability for disability but also for long sick leave.

scholarly journals Positive Outcomes of a Comprehensive Health Literacy Communication Training for Health Professionals in Three European Countries: A Multi-centre Pre-post Intervention Study

2019 ◽  
Vol 16 (20) ◽  
pp. 3923 ◽  
Author(s):  
Marise S. Kaper ◽  
Andrea F. de Winter ◽  
Roberta Bevilacqua ◽  
Cinzia Giammarchi ◽  
Anne McCusker ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Literacy ◽  
Health Professionals ◽  
Intervention Study ◽  
Self Management ◽  
Shared Decision ◽  
Post Intervention ◽  
Self Rated Health ◽  
Comprehensive Health

Many professionals have limited knowledge of how to address health literacy; they need a wider range of health literacy competencies to enhance empowerment and person-centred prevention. We evaluated whether: (1) a comprehensive health literacy training increased self-rated competencies of health professionals to address health literacy related problems and support the development of people’s autonomy and self-management abilities after training and 6–12 weeks later, (2) professionals were satisfied with the training, (3) outcomes differed for the three participating European countries. Health professionals (N = 106) participated in a multicentre pre-post intervention study in Italy, the Netherlands and Northern Ireland. The 8-hour training-intervention involved health literacy knowledge, the practice of comprehensible communication skills, shared decision-making, and enhancing self-management. Self-rated health literacy competencies and training satisfaction were assessed at baseline, immediately after training and 6-12 weeks later, and analysed by multi-level analysis. Professionals’ self-rated health literacy competencies significantly improved following training in all three countries; this increase persisted at 6-12 weeks follow-up. The strongest increase regarded professional’s skills to enhance shared-decision making and enabling self-management after training and follow-up respectively. Professionals perceived the training as relevant for practice. Competency increases seemed to be consistent across countries. In three countries, professionals’ self-rated health literacy competencies increased following this comprehensive training. These promising findings should be confirmed in a further full effect study. Implementation of this training in European education and health care may improve person-centred communication by professionals and might help to tackle health literacy related problems and to strengthen people’s abilities in achieving better health outcomes.

scholarly journals Enhanced infection control interventions reduced catheter-related bloodstream infections in the neonatal department of Hung Vuong Hospital, Vietnam, 2011–2012: a pre- and post-intervention study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Hang Thi Phan ◽  
Thuan Huu Vo ◽  
Hang Thi Thuy Tran ◽  
Hanh Thi Ngoc Huynh ◽  
Hong Thi Thu Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intervention Study ◽  
Bloodstream Infections ◽  
Incidence Rates ◽  
Intervention Period ◽  
Intravenous Catheter ◽  
Aseptic Technique ◽  
Post Intervention ◽  
Post Intervention Period ◽  
Factors Associated

Abstract Background Catheter-related bloodstream infections (CR-BSI) cause high neonatal mortality and are related to inadequate aseptic technique during the care and maintenance of a catheter. The incidence of CR-BSI among neonates in Hung Vuong Hospital was higher than that of other neonatal care centres in Vietnam. Methods An 18-month pre- and post-intervention study was conducted over three 6-month periods to evaluate the effectiveness of the intervention for CR-BSI and to identify risk factors associated with CR-BSI. During the intervention period, we trained all nurses in the Department of Neonatology on BSI preventive practices, provided auditing and feedback about aseptic technique during catheter care and maintenance, and reorganised preparation of total parenteral nutrition. All neonates with intravenous catheter insertion ≥48 h in the pre- and post-intervention period were enrolled. A standardised questionnaire was used to collect data. Blood samples were collected for cultures. We used Poisson regression to calculate rate ratio (RR) and 95% confidence interval (CI) for CR-BSI incidence rates and logistic regression to identify risk factors associated with CR-BSI. Results Of 2225 neonates enrolled, 1027 were enrolled in the pre-intervention period, of which 53 CR-BSI cases occurred in 8399 catheter-days, and 1198 were enrolled in the post-intervention period, of which 32 CR-BSI cases occurred in 8324 catheter-days. Incidence rates of CR-BSI significantly decreased after the intervention (RR = 0.61, 95% CI 0.39–0.94). Days of hospitalisation, episodes of non-catheter–related hospital-acquired infections, and the proportion of deaths significantly decreased after the intervention (p < 0.01). The CR-BSI was associated with days of intravenous catheter (odds ratio [OR] = 1.05, 95% CI 1.03–1.08), use of endotracheal intubation (OR = 2.27, 95% CI 1.27–4.06), and intravenous injection (OR = 8.50, 95% CI 1.14–63.4). Conclusions The interventions significantly decreased the incidence rate of CR-BSI. Regular refresher training and auditing and feedback about aseptic technique during care and maintenance of catheters are critical to reducing CR-BSI.

Using Signage to Promote Stair Use on a University Campus in Hidden and Visible Stairwells

2010 ◽  
Vol 7 (2) ◽  
pp. 232-238 ◽  
Author(s):  
Megan E. Grimstvedt ◽  
Jacqueline Kerr ◽  
Sara B. Oswalt ◽  
Donovan L. Fogt ◽  
Tiffanye M. Vargas-Tonsing ◽  
...  
Keyword(s):  
San Antonio ◽  
University Campus ◽  
Intervention Period ◽  
Post Intervention ◽  
Promotion Strategy ◽  
Quasi Experimental ◽  
University Buildings ◽  
Stair Use ◽  
Experimental Study Design

Background:This study tested the effectiveness of a stair use promotion strategy in visible and hidden stairwells during intervention and post intervention follow up.Methods:A quasi-experimental study design was used with a 1 week baseline, a 3 week intervention, and post intervention at 2 and 4 weeks in 4 university buildings in San Antonio, Texas with stairwells varying in visibility. Participants were students, faculty, staff, and visitors to the 4 buildings. A total of 8431 observations were made. The intervention incorporated motivational signs with direction to nearby stairwells placed by elevators to promote stair use. Stair and elevator use was directly observed and recorded. Logistic regression analyses were used to test whether stair versus elevator use varied by intervention phase and stairwell visibility.Results:Stair use increased significantly (12% units) during the intervention period and remained above baseline levels during post intervention follow-up. At baseline, visible stairs were 4 times more likely to be used than hidden stairs; however, the increase in stair use during intervention was similar in both types of stairwells.Conclusions:Motivational and directional signage can significantly increase stair use on a university campus. Furthermore, stairwell visibility is an important aspect of stair use promotion.

scholarly journals Do work ability and well-being matter for return to work? Cut-off points for the Work Ability Index and Life Satisfaction Questionnaire among women with long-term musculoskeletal pain

2020 ◽  
Author(s):  
Mamunur Rashid ◽  
Marina Heiden ◽  
Annika Nilsson ◽  
Marja-leena Kristofferzon
Keyword(s):  
Life Satisfaction ◽  
Back Pain ◽  
Return To Work ◽  
Work Ability ◽  
Well Being ◽  
Work Ability Index ◽  
Satisfaction Questionnaire ◽  
Ability Index

Abstract Background To determine whether work ability and well-being predict return to work (RTW) among women with long-term neck/shoulder and/or back pain at 1-year follow-up, and to assess the ability of the Work Ability Index (WAI) and Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW). Methods A survey was sent to 600 women receiving sick leave (SL) benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and well-being predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted. Results Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04–1.22). Well-being was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after one year (AUC 0.78, 95% CI: 0.70–0.86), but the LiSat-11 did not. Conclusions Our results indicate that work ability is an important factor for RTW among women on SL for long-term neck/shoulder and/or back pain. The findings also indicate that the WAI, but not the LiSat-11, is able to discriminate between RTW and NRTW in the population under study. The WAI may be used to identify women at risk of NRTW.

scholarly journals EFFECTS OF TELEHEALTH PROGRAM ON FUNCTIONAL MOBILITY AMONG ELDERLY WITH DEMENTIA: PRELIMINARY RESULTS

2021 ◽  
Author(s):  
Carolina Tsen ◽  
Juliana Ansai ◽  
Grace Gomes ◽  
Décio Neto ◽  
Renata Gerassi ◽  
...  
Keyword(s):  
Functional Mobility ◽  
Control Group ◽  
Intervention Period ◽  
Risk Of Falling ◽  
Post Intervention ◽  
Timed Up And Go ◽  
Physical Test ◽  
Intervention Evaluation ◽  
And Control

Background: Telehealth is and alternative to improve functional mobility of elderly with dementia on a pandemic scenario, but still little explored on Brazil. Objective: To analyze the effects of a telehealth program on functional mobility among elderly with dementia. Methods: Ten elderly with dementia were evaluated about functional capacity through physical test Timed Up and Go. After, they were randomized and divided into two groups: telehealth group (TG) and control group (CG). The TG performed systematic physical and cognitive exercises with professional monitoring, while the CG received non-systematized guidance, both for 12 weeks. Participants were evaluated pre, immediately after three-month intervention and with a 12- week follow-up. Results: Of the 10 participants, 5 were allocated to each group. In the pre-intervention evaluation, the CG had a mean of 15.64 +/- 5.04 seconds in the TUG test and the TG had a mean of 19.78 +/- 6.51, that is, above 12.45 seconds means risk of falling. In the post-intervention, the CG had a mean of 16.83 +/- 6.77 and the TG a mean of 25.22 +/- 19.50. After 3 months of follow-up, the CG and the TG showed a mean of 16.08 +/- 2.04 and 17.98 +/- 6.73, respectively. Conclusion: After the intervention period, due to the small number of the sample, it was not possible to verify improvement in either group.

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