scholarly journals ETHNIC BACKGROUND DOES NOT INFLUENCE OUTCOME FOR RETURN-TO-WORK IN WORK-RELATED INTERDISCIPLINARY REHABILITATION FOR LONG-TERM PAIN: 1- AND 3-YEAR FOLLOW-UP

2006 ◽  
Vol 38 (2) ◽  
pp. 87-92 ◽  
Author(s):  
Jan-Rickard Norrefalk ◽  
Jan Ekholm ◽  
Kristian Borg
Keyword(s):  
Return To Work ◽  
Ethnic Background ◽  
Work Related ◽  
Interdisciplinary Rehabilitation

scholarly journals LO95: A prospective evaluation of mild traumatic brain injuries in a working population in Edmonton, AB

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S61
Author(s):  
L. Gaudet ◽  
L. Eliyahu ◽  
J. Lowes ◽  
J. Beach ◽  
M. Mrazik ◽  
...  
Keyword(s):  
Return To Work ◽  
Attention Deficit Disorder ◽  
Brain Injuries ◽  
Work Outcomes ◽  
Continuous Variables ◽  
Chi Square ◽  
Work Related ◽  
Persistent Symptoms ◽  
History Of

Introduction: Patients with mild traumatic brain injury (mTBI) frequently present to the emergency department (ED); however, wide variation in diagnosis and management has been demonstrated in this setting. Sub-optimal mTBI management can contribute to post-concussion syndrome (PCS), affecting vocational outcomes like return to work. This study documented the work-related events, ED management, discharge advice, and outcomes for employed patients presenting to the ED with mTBI. Methods: Adult (>17 years) patients presenting to one of three urban EDs in Edmonton, Alberta with Glasgow coma scale score ≥13 within 72 hours of a concussive event were recruited by on-site research assistants. Follow-up calls ascertained outcomes, including symptoms and their severity, advice received in the ED, and adherence to discharge instructions, at 30 and 90 days after ED discharge. Dichotomous variables were analyzed using chi-square testing; continuous variables were compared using t-tests or Mann-Whitney tests, as appropriate. Work-related injury and return to work outcomes were modelled using logistic or linear regression, as appropriate. Results: Overall, 250 patents were enrolled; 172 (69%) were employed at the time of their injury and completed at least one follow-up. The median age was 37 years (interquartile range [IQR]: 24, 49.5), both sexes were equally represented (48% male), and work-related concussions were uncommon (16%). Work-related concussion was related to manual labor jobs and self-reported history of attention deficit disorder. Patients often received advice to avoid sports (81%) and/or work (71%); however, the duration of recommended time off varied. Most employed patients (80%) missed at least one day of work (median=7 days; IQR: 3, 14); 91% of employees returned to work by 90 days, despite 41% reporting persistent symptoms. Increased days of missed work were linked to divorce, history of sleep disorder, and physician’s advice to avoid work. Conclusion: While work-related concussions are uncommon, most employees who sustain a mTBI at any time miss some work. Many patients experience mTBI symptoms past 90 days, which has serious implications for workers’ abilities to fulfill their work duties and risk of subsequent injury. Workers, employers, and the workers compensation system should take the necessary precautions to ensure that workers return to work safely and successfully following a concussion.

Long-Term Complications and Influence on Outcome in Patients Surviving Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 49 (3) ◽  
pp. 307-315 ◽  
Author(s):  
Stefan T. Gerner ◽  
Jonathan Reichl ◽  
Christina Custal ◽  
Sebastian Brandner ◽  
Ilker Y. Eyüpoglu ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Return To Work ◽  
Functional Outcome ◽  
Subjective Health ◽  
Study Cohort ◽  
Vp Shunt ◽  
Multivariable Analyses ◽  
Favorable Functional Outcome

Background: While the short-term clinical outcome of patients with subarachnoid hemorrhage (SAH) is well described, there are limited data on long-term complications and their impact on social reintegration. This study aimed to assess the frequency of complications post-SAH and to investigate whether these complications attribute to functional and self-reported outcomes as well as the ability to return to work in these patients. Methods: This retrospective single-center study included patients with atraumatic SAH over a 5-year period at a tertiary care center. Patients received a clinical follow-up for 12 months. In addition to demographics, imaging data, and parameters of acute treatment, the rate and extent of long-term complications after SAH were recorded. The functional outcome was assessed using the modified Rankin Scale (mRS; favorable outcome defined as mRS = 0–2). Further outcomes comprised self-reported subjective health measured by the EQ-5D and return to work for SAH patients with appropriate age. Multivariable analyses including in-hospital parameters and long-term complications were conducted to identify parameters independently associated with outcomes in SAH survivors. Results: This study cohort consisted of 505 SAH patients of whom 405 survived the follow-up period of 12 months (i.e., mortality rate of 19.8%). Outcome data were available in 359/405 (88.6%) patients surviving SAH. At 12 months, a favorable functional outcome was achieved in 287/359 (79.9%) and 145/251 (57.8%) SAH patients returned to work. The rates of post-acute complications were headache (32.3%), chronic hydrocephalus requiring permanent ventriculoperitoneal shunting (VP shunt 25.4%) and epileptic seizures (9.5%). Despite patient’s and clinical characteristics, both presence of epilepsy and need for VP shunt were independently and negatively associated with a favorable functional outcome (epilepsy: adjusted odds ratio [aOR] (95% confidence interval [95% CI]): 0.125 [0.050–0.315]; VP shunt: 0.279 [0.132–0.588]; both p < 0.001) as well as with return to work (aOR [95% CI]: epilepsy 0.195 [0.065–0.584], p = 0.003; VP shunt 0.412 [0.188–0.903], p = 0.027). Multivariable analyses revealed presence of headache, VP shunt, or epilepsy to be significantly related to subjective health impairment (aOR [95% CI]: headache 0.248 [0.143–0.430]; epilepsy 0.223 [0.085–0.585]; VP shunt 0.434 [0.231–0.816]; all p < 0.01). Conclusions: Long-term complications occur frequently after SAH and are associated with an impairment of functional and social outcomes. Further studies are warranted to investigate if treatment strategies specifically targeting these complications, including preventive aspects, may improve the outcomes after SAH.

Use of Motivational Interviewing to Improve Return-to-work and Work-related Outcomes: A Review

2014 ◽  
Vol 20 (1) ◽  
pp. 38-49 ◽  
Author(s):  
Kathryn M. Page ◽  
Irina Tchernitskaia
Keyword(s):  
Literature Review ◽  
Return To Work ◽  
Motivational Interviewing ◽  
Work Disability ◽  
Clinical Settings ◽  
Negative Effects ◽  
Work Related ◽  
Health Behaviour Change ◽  
Behavioural Factors

Work-based return-to-work (RTW) interventions can help to reduce the duration and cost of work disability, and in turn, prevent the negative effects of long-term sickness absence. However, there are a number of complex cognitive, affective and behavioural factors that can impact an individual's confidence, motivation and willingness to RTW that need to be addressed to facilitate effective outcomes. This literature review investigates evidence for the use of motivational interviewing (MI) for improving return-to-work (RTW) and employment outcomes. Whilst evidence for the efficacy of MI in clinical settings to motivate health behaviour change is strong, more research is needed to determine whether MI can be usefully applied to improve RTW and other work-related outcomes.

scholarly journals Nurses’ Perspectives on Patient and Visitor Violence: A Qualitative Study

2018 ◽  
Vol 3 (2) ◽  
pp. 117
Author(s):  
Lannette Henderson ◽  
Brittany Kamp ◽  
Keri Niedbalski ◽  
Samuel P. Abraham ◽  
Deborah R. Gillum
Keyword(s):  
Lived Experiences ◽  
Research Study ◽  
Work Related ◽  
Need For Support ◽  
Qualitative Phenomenological ◽  
Phenomenological Design ◽  
And Training ◽  
Consequences Of Violence

The profession of nursing is at high risk for work-related threats and violence from patients and visitors. The purpose of this study was to investigate nurses’ perspectives on patient and visitor violence. In this research study, a qualitative, phenomenological design was used. The study question was, “What are your lived experiences as a nurse with patient and visitor violence?” This study included what nurses have personally experienced and how they handled violent situations while performing their job. A total of 19 registered nurses were interviewed. Open-ended questions and follow-up probes evoked responses. Sequential interviews were conducted until all concepts were repeated multiple times without new themes emerging. Four common themes emerged were violence (punching, kicking, tackling, pinching, and spitting), long-term consequences of violence, need for education and training for violence, and the need for support from the organization. Taylor’s cognitive adaptation adjustments to threatening events theory helped guide the study.

Long-term sick leave and graded return to work: What do we know about the follow-up effects?

Health Policy ◽  
2016 ◽  
Vol 120 (10) ◽  
pp. 1193-1201 ◽  
Author(s):  
Udo Schneider ◽  
Roland Linder ◽  
Frank Verheyen
Keyword(s):  
Sick Leave ◽  
Return To Work

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 an Internet-Based Cognitive Behavioral Therapy for Insomnia Program on Work Productivity: A Secondary Analysis

2020 ◽  
Author(s):  
Kelly M Shaffer ◽  
Eric A Finkelstein ◽  
Fabian Camacho ◽  
Karen S Ingersoll ◽  
Frances Thorndike ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Secondary Analysis ◽  
Work Productivity ◽  
Cognitive Behavioral ◽  
Activity Impairment ◽  
Work Related ◽  
Post Assessment

Abstract Background Cognitive-behavioral therapy for insomnia (CBT-I) may improve productivity along with insomnia symptoms, but the long-term duration of productivity gains is unknown. Purpose In this secondary analysis, effects of Internet-delivered CBT-I on work-related and daily activity productivity were examined through 1 year post-treatment. Methods Adults with chronic insomnia (N = 303) were randomized to Internet-delivered CBT-I (Sleep Healthy Using the Internet [SHUTi]) or to patient education (PE). Participants reported interference with attendance (absenteeism) and productivity (presenteeism) at paid employment and in daily activities outside work on the Work Productivity Activity Impairment scale at baseline, 9 weeks later for postintervention assessment (post-assessment), and 6- and 12-month follow-ups. Results Participants randomized to SHUTi were about 50% less likely than those in the PE condition to report any absenteeism (logistic regression odds ratio [OR] = 0.48 [95% confidence intervals {CI} = 0.24,0.96]), total impairment (OR = 0.52 [95% CI = 0.29,0.93]), or activity impairment (OR = 0.50 [95% CI = 0.30,0.85]) at post-assessment; however, differences were not detected at 6- or 12-month follow-ups. SHUTi participants also reported lower overall levels of presenteeism (constrained longitudinal data analysis MDiff = −6.84 [95% CI = −11.53, −2.15]), total impairment (MDiff = −7.62 [95% CI = −12.50, −2.73]), and activity impairment (MDiff = −7.47 [95% CI = −12.68, −2.26]) at post-assessment relative to PE participants. Differences were sustained at 6-month follow-up for presenteeism (MDiff = −5.02 [95% CI = −9.94, −0.10]) and total impairment (MDiff = −5.78 [95% CI = −10.91, −0.65]). No differences were detected by 12-month follow-up. Conclusions Findings suggest that Internet-based CBT-I may help accelerate improvement in work-related and daily activity impairment corroborating prior research, but did not find that CBT-I has persistent, long-term benefits in productivity relative to basic insomnia education. Trial Registration NCT00328250 “Effectiveness of Internet Cognitive Behavioral Therapy Intervention for Treating Insomnia” (https://clinicaltrials.gov/ct2/show/NCT00328250).

Key Push and Pull Factors Affecting Return to Work Identified by Patients With Long-Term Pain and General Practitioners in Sweden

2019 ◽  
Vol 29 (11) ◽  
pp. 1581-1594 ◽  
Author(s):  
Tove Lundberg ◽  
Stina Melander
Keyword(s):  
Return To Work ◽  
General Practitioners ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Factors Affecting ◽  
Individual Motivation ◽  
Push And Pull Factors ◽  
Work Related ◽  
Push And Pull

Research shows that working is positive for people with long-term pain but that work-related support from health professionals is inadequate. One explanation for this inadequacy is that patients and providers differ in terms of perspectives on motivation to work. In this article, we compare factors that 31 patients and 15 general practitioners consider important to promote return to work for people with long-term pain. We analyzed the interviews with thematic analysis and a motivational push and pull framework to cover different motivational factors, societal and individual, that might push or pull patients from or toward work. Providers said that a difference between working and nonworking patients is their level of individual motivation, while the patients’ stories showed that the main difference was the physical (non)ability to push themselves to work. We suggest that work-related support can be improved by addressing such differences in clinical practice.

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