Comparison of Two Multidisciplinary Occupational Rehabilitation Programs Based on Multimodal Cognitive Behavior Therapy on Self-Rated Health and Work Ability

Objective: Musculoskeletal pain and common mental disorders constitute the largest proportion of people who are on sick leave. This study investigated the efficacy of two multidisciplinary occupational rehabilitation programs on self-rated health and work-related outcomes. The interventions were identical in content but differed in length. It was hypothesized that a longer inpatient program would yield greater improvements than a shorter outpatient program.Methods: Patients were sick-listed workers referred to occupational rehabilitation by the Norwegian Labor and Welfare Administration. A non-randomized 2 Condition (20 days, n = 64 versus 12 days, n = 62) × 4 repeated measures (start, end, 3 months, 12 months) between-subject design was used. Both programs were based on multimodal cognitive behavior therapy with a return-to-work focus. Health-related questionnaires were the Subjective Health Complaints inventory, Hospital Anxiety and Depression Scale, and SF-36 Bodily Pain. Work-related questionnaires were the Work Ability Index, the Fear-Avoidance Beliefs Questionnaire, Return To Work Self-Efficacy, and Return To Work expectations. Intervention effects were estimated using linear mixed models and Cohen’s d.Results: The results revealed that both groups improved on the selected outcomes. Within-group contrasts and effect sizes showed that the inpatient group showed larger effect sizes at the end of rehabilitation and 12 months post-intervention for work-related outcomes than the outpatient group.Conclusion: Both programs were efficacious in improving health- and work-related outcomes during and after rehabilitation, but the inpatient group generally displayed stronger and more rapid improvements and was more stable at one-year postintervention.

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Faculty Opinions recommendation of Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13853958.15292058 ◽

2012 ◽

Author(s):

Jean Addington

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Effect Sizes ◽

Cognitive Behavior ◽

Methodological Rigor ◽

Clinical Models

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Cognitive Behavior Therapy for Schizophrenia: Effect Sizes, Clinical Models, and Methodological Rigor

Schizophrenia Bulletin ◽

10.1093/schbul/sbm114 ◽

2007 ◽

Vol 34 (3) ◽

pp. 523-537 ◽

Cited By ~ 621

Author(s):

T. Wykes ◽

C. Steel ◽

B. Everitt ◽

N. Tarrier

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Effect Sizes ◽

Cognitive Behavior ◽

Methodological Rigor ◽

Clinical Models

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Functional Capacity Evaluation for Work-Related Injuries to the Foot and Ankle is Associated with Low Return to Work Rate

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00227 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0022

Author(s):

Alexander J. Idarraga ◽

Adam Wright-Chisem ◽

Daniel D. Bohl ◽

Simon Lee ◽

Johnny Lin ◽

...

Keyword(s):

Return To Work ◽

Functional Capacity ◽

Work Ability ◽

Functional Capacity Evaluation ◽

Foot And Ankle ◽

Inclusion Criteria ◽

Work Related ◽

Work Related Injury ◽

Capacity Evaluation ◽

Light Medium

Category: Hindfoot, Ankle, Midfoot/Forefoot, Injury and Rehabilitation Introduction/Purpose: The functional capacity evaluation (FCE) is used to determine a worker’s physical ability after treatment of a work-related injury. This evaluation is a critical determinant in the administration of benefits and the decision to return to work (RTW). The purpose of this study is to characterize FCE results and ability to RTW among patients treated for work- related orthopaedic injuries to the foot or ankle. Methods: A retrospective medical record review from the practices of four orthopaedic foot and ankle surgeons was conducted. Inclusion criteria were (1) treatment of a work-related injury to the foot or ankle, (2) at least 2 years of follow-up from the injury, and (3) documentation of an associated FCE. The FCE report and clinic notes were used to determine the patient’s pre-injury job requirement (Department of Labor Office category: light, medium, or heavy), post-injury FCE-determined work ability (light, medium, or heavy), specific FCE- or physician-imposed work restrictions, and clearance for RTW. Patients were considered cleared to RTW if their FCE-determined work ability met or exceeded their pre-injury job requirement and if there were no additional restrictions imposed by the FCE or physician that would prevent them from functioning in their pre-injury role. Results: A total of 188 patients met inclusion criteria. Missteps/rotational injuries (44.1%), falls from height (22.3%), and crush injuries (20.7%) were the most common mechanisms. 74.4% of patients had FCE-determined work abilities at or above their pre- injury job requirements, and 63.3% of patients were eventually cleared for RTW. The median time from injury to clearance for RTW was 2.0 ± 1.3 years. Reasons for not being cleared to RTW included failure to meet the pre-injury job requirement (67.2%), specific FCE-imposed limitations (28.3%), or specific physician-imposed limitations (4.5%). Less strenuous pre-injury job requirement was positively associated with both FCE-determined work ability meeting pre-injury job requirement and clearance for RTW (p<0.001 and p=0.034, respectively; Table 1). Conclusion: Approximately two-thirds of patients undergoing FCE after a work-related foot or ankle injury are cleared to RTW. However, it takes a median of two years to achieve this clearance. Patients with jobs that are more physically strenuous are less likely to be able to return to those jobs after injury to the foot or ankle.

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Impact of interventions on work-related outcomes for individuals with musculoskeletal injuries after road traffic crash: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-019-1178-2 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Charlotte L. Brakenridge ◽

Elise M. Gane ◽

Esther J. Smits ◽

Nicole E. Andrews ◽

Venerina Johnston

Keyword(s):

Systematic Review ◽

Sick Leave ◽

Return To Work ◽

Work Ability ◽

Road Traffic ◽

Musculoskeletal Injury ◽

Musculoskeletal Injuries ◽

Road Traffic Crash ◽

Traffic Crash ◽

Work Related

Abstract Background Musculoskeletal injuries are the most common non-fatal injury from road traffic crashes. Even when the injuries are mild, they can cause pain which can affect return to work rates and work ability post-crash. Workplace output losses are the biggest cost from traffic crash-related injuries. There is a need to identify effective interventions that can improve work-related outcomes (e.g. time to return to work, sick leave, and work ability) in this group and a need to understand the intervention components, external factors, and participant characteristics that may be associated with improvement. Methods A systematic review will be conducted using seven databases and search terms related to road traffic crash, musculoskeletal injury, work-related outcomes, and study design. Intervention studies will be eligible if they report on at least one work-related outcome, include adults with a traffic crash-related musculoskeletal injury (e.g. fracture or whiplash), include a comparison group, and are written in English. Interventions can be medical, therapeutic, work-based, multicomponent, or other. Two researchers will independently screen titles and abstracts, review full texts for inclusion in the review, and perform the data extraction. The main outcomes of the review will be time until return to work and duration of sick leave. The results will be narratively described, with meta-analyses conducted where possible. Discussion This review will explore the effectiveness of interventions in individuals with traffic crash-related musculoskeletal injury on work-related outcomes and will act as a useful source for researchers, policy makers, and stakeholders when developing and implementing interventions in this group. Systematic review registration PROSPERO CRD42018103746

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The impact of internet-based cognitive behavior therapy on work ability in patients with depression – a randomized controlled study

International Journal of General Medicine ◽

10.2147/ijgm.s129710 ◽

2017 ◽

Vol Volume 10 ◽

pp. 151-159 ◽

Cited By ~ 4

Author(s):

Dominique Hange ◽

Nashmil Ariai ◽

Marie Kivi ◽

Maria Eriksson ◽

Shabnam Nejati ◽

...

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Work Ability ◽

Randomized Controlled Study ◽

Controlled Study ◽

Cognitive Behavior ◽

Randomized Controlled ◽

The Impact

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Randomized Controlled Clinical Effectiveness Trial of Cognitive Behavior Therapy Compared With Treatment As Usual for Persistent Insomnia in Patients With Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2007.13.9006 ◽

2008 ◽

Vol 26 (28) ◽

pp. 4651-4658 ◽

Cited By ~ 221

Author(s):

Colin A. Espie ◽

Leanne Fleming ◽

James Cassidy ◽

Leslie Samuel ◽

Lynne M. Taylor ◽

...

Keyword(s):

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Gynecological Cancer ◽

Clinical Effectiveness ◽

Effect Sizes ◽

Sleep Diary ◽

Cognitive Behavior ◽

Treatment As Usual ◽

Randomized Controlled ◽

Time In Bed

Purpose Persistent insomnia is a common complaint in cancer survivors, but is seldom satisfactorily addressed. The adaptation to cancer care of a validated, cost-effective intervention may offer a practicable solution. The aim of this study was to investigate the clinical effectiveness of protocol-driven cognitive behavior therapy (CBT) for insomnia, delivered by oncology nurses. Patients and Methods Randomized, controlled, pragmatic, two-center trial of CBT versus treatment as usual (TAU) in 150 patients (103 females; mean age, 61 years.) who had completed active therapy for breast, prostate, colorectal, or gynecological cancer. The study conformed to CONSORT guidelines. Primary outcomes were sleep diary measures at baseline, post-treatment, and 6-month follow-up. Actigraphic sleep, health-related quality of life (QOL), psychopathology, and fatigue were secondary measures. CBT comprised five, small group sessions across consecutive weeks, after a manualized protocol. TAU represented normal clinical practice; the appropriate control for a clinical effectiveness study. Results CBT was associated with mean reductions in wakefulness of 55 minutes per night compared with no change in TAU. These outcomes were sustained 6 months after treatment. Standardized relative effect sizes were large for complaints of difficulty initiating sleep, waking from sleep during the night, and for sleep efficiency (percentage of time in bed spent asleep). CBT was associated with moderate to large effect sizes for five of seven QOL outcomes, including significant reduction in daytime fatigue. There was no significant interaction effect between any of these outcomes and baseline demographic, clinical, or sleep characteristics. Conclusion CBT for insomnia may be both clinically effective and feasible to deliver in real world practice.

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Comparing two interdisciplinary occupational rehabilitation programs for employees on sick leave: a mixed-method design study protocol

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03994-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Monica Eftedal ◽

Torill H. Tveito ◽

Ulrik Gensby ◽

M. Kamrul Islam ◽

Stein Atle Lie ◽

...

Keyword(s):

Sick Leave ◽

Return To Work ◽

Mixed Method ◽

Common Mental Disorders ◽

Inpatient Rehabilitation ◽

Occupational Rehabilitation ◽

Rehabilitation Program ◽

Interdisciplinary Teams ◽

Full Time ◽

Rehabilitation Programs

Abstract Background Musculoskeletal disorders (MSDs) and common mental disorders (CMDs) are the most frequent reasons for long-term sick leave and work disability. Occupational rehabilitation programs are used to help employees return to work (RTW). However, knowledge regarding the effect of these programs is scarce, and even less is known about which programs are best suited for which patients. This study aims to compare the RTW results of two interdisciplinary occupational rehabilitation programs in Norway, as well as to examine the delivery and reception of the two programs and explore the active mechanisms of the participants’ RTW processes. Methods/design We will use a mixed-method convergent design to study the main outcome. Approximately 600 participants will be included in the study. Eligible study participants will be aged 18–60 years old and have been on sick leave due to MSDs, CMDs, or both for at least 6 weeks. Interdisciplinary teams at both participating clinics will deliver complex occupational rehabilitation programs. The inpatient rehabilitation program has a duration of 4 weeks and is full time. The outpatient program has a duration of 3 months and involves weekly sessions. The primary outcome is RTW. Secondary outcomes are differences in the incremental cost for an averted sick leave day, cost utility/benefit, and differences between the programs regarding improvements in known modifiable obstacles to RTW. Subgroup analyses are planned. The researchers will be blinded to the intervention groups when analyzing the quantitative RTW data. Discussion This study aims to provide new insights regarding occupational rehabilitation interventions, treatment targets, and outcomes for different subgroups of sick-listed employees and to inform discussions on the active working mechanisms of occupational rehabilitation and the influence of context in the return-to-work process. Trial registration Current controlled trials ISRCTN12033424, 15.10.2014, retrospectively registered.

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A social-healthcare pathway to facilitate return to work of cancer survivors in Italy: The UNAMANO project

Work ◽

10.3233/wor-205249 ◽

2021 ◽

pp. 1-11

Author(s):

Sara Paltrinieri ◽

Elena Ricchi ◽

Elisa Mazzini ◽

Elena Cervi ◽

Elisa Sandri ◽

...

Keyword(s):

Return To Work ◽

Cancer Survivors ◽

Job Search ◽

Occupational Rehabilitation ◽

Individual Risk ◽

Work Related ◽

Local Branch ◽

Training Institutions ◽

Nonprofit Associations ◽

Personalized Intervention

BACKGROUND: Return to work (RTW) is a major goal to promote cancer survivors’ social participation. OBJECTIVE: This study describes the multidisciplinary social-healthcare pathway called UNAMANO, conceived to support RTW in this population. METHODS: UNAMANO was developed by the Azienda USL-IRCCS di Reggio Emilia, in partnership with the local branch of the Italian Medical Association, nonprofit associations, vocational training institutions, social cooperatives, a labour union, and a chartered accounting firm. RESULTS: UNAMANO is directed towards employed individuals diagnosed with cancer living in the province of RE. It was developed through four actions: A) training healthcare professionals on work-related occupational rehabilitation; B) dissemination among community and stakeholders; C) recruitment and training of volunteers; D) cancer survivor engagement and provision of a personalized comprehensive intervention. This consists in providing information and either occupational therapy to overcome barriers and facilitate RTW or social support through re-training and tailored job search strategies based on individual risk of job loss. CONCLUSIONS: UNAMANO is the first Italian multidisciplinary social-healthcare pathway supporting RTW of cancer survivors. Addressing a wide area of cancer survivors’ needs, it provides personalized intervention to resolve work-related issues. We propose this patient-centred RTW model to promote an easier transition from hospital to community.

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A Social-Healthcare Pathway to Facilitate Return to Work of Cancer Survivors in Italy: Implementation Process of the UNAMANO project

10.21203/rs.2.17663/v1 ◽

2019 ◽

Author(s):

Sara Paltrinieri ◽

Elena Ricchi ◽

Elisa Mazzini ◽

Elena Cervi ◽

Stefania Fugazzaro ◽

...

Keyword(s):

Return To Work ◽

Cancer Survivors ◽

Job Search ◽

Implementation Process ◽

Well Being ◽

Occupational Rehabilitation ◽

Health Condition ◽

Work Related ◽

Local Branch ◽

Nonprofit Associations

Abstract Purpose Return to work (RTW) is a major goal to promote cancer survivors’ social participation. A multidisciplinary social-healthcare pathway called UNAMANO was designed to support RTW in this population. Methods UNAMANO was developed by the Azienda USL – IRCCS di Reggio Emilia (RE), in partnership with the local branch of the Italian Medical Association, nonprofit associations, vocational training institutions, social cooperatives, a labour union, and a chartered accounting firm. Results UNAMANO is directed towards employed individuals diagnosed with cancer living in the Province of RE. It has been implemented through four actions: A) healthcare professionals training on work-related occupational rehabilitation; B) dissemination among community and stakeholders; C) recruitment and training of volunteers; D) cancer survivor engagement and provision of a personalized comprehensive intervention. This consists in providing information and occupational therapy to overcome barriers and facilitate RTW or social support through re-training and tailored job search strategies for individuals based on their risk of job loss. Conclusions UNAMANO is the first Italian multidisciplinary social-healthcare pathway supporting RTW of cancer survivors. Addressing a wide area of cancer survivors’ needs, it provides personalized intervention to resolve work-related issues. We propose this patient-centred RTW model to promote an easier transition from hospital to community.Implications for cancer survivors UNAMANO can positively impact on cancer survivors’ health and well-being and can be provided at any stage of disease and treatment. UNAMANO ensures that RTW is coherent with cancer survivors’ health condition and expectations.

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