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WORK: A Journal of Prevention, Assessment & Rehabilitation is an interdisciplinary, international journal which publishes high quality peer-reviewed manuscripts covering the entire scope of the occupation of work. The journal's subtitle has been deliberately laid out: The first goal is the prevention of illness, injury, and disability. When this goal is not achievable, the attention focuses on assessment to design client-centered intervention, rehabilitation, treatment, or controls that use scientific evidence to support best practice.
WORK occasionally publishes thematic issues, but in general, issues cover a wide range of topics such as ergonomic considerations with children, youth and students, the challenges facing an aging workforce, workplace violence, injury management, performing artists, ergonomic product evaluations, and the awareness of the political, cultural, and environmental determinants of health related to work.
Dr. Karen Jacobs, the founding editor, and her editorial board especially encourage the publication of research studies, clinical practice, case study reports, as well as personal narratives and critical reflections of lived work experiences (autoethnographic/autobiographic scholarship),
Sounding Board commentaries and
Speaking of Research articles which provide the foundation for better understanding research to facilitate knowledge dissemination.
Narrative Reflections on Occupational Transitions, a new column, is for persons who have successfully transitioned into, between, or out of occupations to tell their stories in a narrative form. With an internationally renowned editorial board,
WORK maintains high standards in the evaluation and publication of manuscripts. All manuscripts are reviewed expeditiously and published in a timely manner.
WORK prides itself on being an author-friendly journal.
WORK celebrates its 25th anniversary in 2015.
*WORK is affiliated with the Canadian Association of Occupational Therapists (CAOT)* *WORK is endorsed by the International Ergonomics Association (IEA)* *WORK gives out the yearly Cheryl Bennett Best Paper Award*
Abstract: Objective: To investigate slow and fast paced industrial activity hand repetitive movements associated with carpal tunnel syndrome where movements are evaluated based on finger and wrist tendon travel measurements. Methods: Nine healthy subjects were recruited for the study aged between 23 and 33 years. Participants mimicked an industrial repetitive task by performing the following activities: wrist flexion and extension task, palm open and close task; and pinch task. Each task was performed for a period…of 5 minutes at a slow (0.33 Hz) and fast (1 Hz) pace for a duration of 3 minutes and 2 minutes respectively. Results: Tendon displacement produced higher flexor digitorum superficialis (FDS) tendon travel when compared to the flexor digitorum profundus (FDP) tendons. The left hand mean (SD) tendon travel for the FDS tendon and FDP tendon were 11108 (5188) mm and 9244 (4328) mm while the right hand mean tendon travel (SD) for the FDS tendon and FDP tendon were 9225 (3441) mm and 7670 (2856) mm respectively. Of the three tasks mimicking an industrial repetitive activity, the wrist flexion and extension task produced the most tendon travel. Conclusion: The findings may be useful to researchers in classifying the level of strenuous activity in relation to tendon travel.
Abstract: Objective: The aim was to explore aspects of everyday life in addition to established risk factors and their relationship to subjective health and well-being among public sector employees in Sweden. Gainful employment impact on employees' health and well-being, but work is only one part of everyday life and a broader perspective is essential in order to identify health-related factors. Participants: Data were obtained from employees at six Social Insurance Offices in Sweden, 250 women…and 50 men. Method: A questionnaire based on established instruments and questions specifically designed for this study was used. Relationships between five factors of everyday life, subjective health and well-being were investigated by means of multivariate logistic regression analysis. Results: The final model revealed a limited importance of certain work-related factors. A general satisfaction with everyday activities, a stress-free environment and general control in addition to not having monotonous movements at work were found to be factors explaining 46.3% of subjective good health and well-being. Conclusions: A person's entire activity pattern, including work, is important, and strategies for promoting health should take into account the person's situation as a whole. The interplay between risk and health factors is not clear and further research is warranted.
Keywords: Work-life balance, stress, subjective health
Abstract: Ergonomic research on nursing work has focused primarily on the biomechanical analysis of patient handling tasks. Few studies have addressed the intensity of a full day of nursing work as measured by changes in heart rate and energy expenditure. Objective: A pilot study was conducted between August 2009 and May 2010 to examine the intensity of performing nursing assistant work in long term care settings and to assess the usefulness of heart rate monitoring as a…measure of work intensity. The residents of the facilities were physically dependent adults. The settings had floor-based mechanical lifting devices available and no-lift policies that restricted workers from lifting. Participants: Eight women between the ages of 19 and 54 from two facilities participated in this study. Methods: A wearable recorder allowed unobtrusive heart rate monitoring while nursing assistants worked their usual shift. Continuous heart rate monitoring for a full shift provided an estimation of energy expenditure. Results: The data suggest that the nursing assistants worked at a moderate level yet were within the safe work intensity level recommended by NIOSH . Conclusions: The information provides preliminary baseline data for nursing assistants who work with physically dependent adults using floor-based lifts in a no-lift environment.
Abstract: Objective: The goals of this project were to improve the understanding of risk factors that may lead to injury and increased turnover in home health aides, discover unexplored opportunities for intervention, and test those intervention ideas for potential effects, feasibility, and acceptance by home health aides and their employers. Methods: Analysis of injury data, extensive direct observation and analysis of aide-patient interactions, participatory intervention ideation focus group discussions, and intervention pilot testing was conducted.…Results: A method of categorizing each patient's level of skill in transfer and bathing activities, and their mobility assistance requirements was developed from information collected during the study as well as a review of the literature. In a pilot test, the new categorization scheme was used to control the aides' daily exposure to higher needs patients. The percentage of time that aides worked with patients in higher needs categories was found to be related to the aides' self-reports of end-of-shift fatigue and pain. Conclusion: Home health care companies may find that developing a scheduling system that manages the exposure of their aides to higher needs patients may be a feasible and effective method for reducing the aides' exposure to risk factors for musculoskeletal injuries.
Keywords: Home health aide, musculoskeletal disorder, risk factor exposure control, patient handling
Abstract: Objective: Three-fourths of diagnostic medical sonographers (DMS) and vascular technologists (VT) experiencing discomfort due to job demands indicate having discomfort in the shoulder region. An analysis of factors related to shoulder discomfort highlighted salient factors requiring further investigation and intervention. Participants: The respondents were a convenient sample of DMS and VT that answered a survey, hosted on a secure website. Methods: The responses of 2,163 DMS and VT from a survey of a…representative sample were analyzed to determine personal factors, work demands, and workstation design characteristics of those experiencing discomfort in the shoulder region. Frequencies and response distributions were calculated and cross tabulation with chi-square analysis was completed. Results: A majority of respondents with shoulder discomfort have co-morbid reports of discomfort in other locations. While overall sonographer discomfort is linked to age and years of experience, shoulder discomfort was also noted to be linked to specific workstation characteristics. A lack of adjustability in equipment, picture archiving and communication system (PACS) workstations, awkward and positions required to complete bedside exams contributes to discomfort due to sustained and repetitive shoulder abduction and twisting of the neck and trunk. Conclusions: There is a need for studies investigating redesign of equipment and workstations or interventions with DMS and VT specifically focused on improving adjustability and improved positioning of sonographers in order to reduce shoulder discomfort while performing job demands.
Keywords: Work-related musculoskeletal disorders, ergonomics, human factors
Abstract: Work-related musculoskeletal disorders (WRMSD) in sonographers have increased over the past 20 years with shoulder injuries being the most prevalent. Advancing ultrasound technologies have reduced a sonographer's need to move when performing exams and increased prolonged arm abduction, resulting in static work postures and decreased joint perfusion. Work modifications in other industries have demonstrated that reducing arm abduction to 30° reduces muscle firing and fatigue. Although this is the ideal work posture for…sonographers, there are many instances in which excessive arm abduction and static postures cannot be avoided. These positions are further complicated by the fact that the scanning arm is also supporting the weight of the ultrasound transducer. This observational case study evaluated the use of a moveable arm support system as a means to provide support for the scanning arm and reduce muscle firing during ultrasound exams in the scanning lab of a university diagnostic ultrasound educational program.
Keywords: Musculoskeletal injuries, arm support device, shoulder abduction, occupational injuries
Abstract: Objective: The purpose of this study was to examine work activities associated with work-related injury (WRI) in occupational and physical therapy. Participants: 1,158 occupational and physical therapists in Wisconsin responded to a mailed survey, from a total of 3,297 OTs and PTs randomly selected from the State licensure list. Methods: The study used a cross-sectional, survey design. Participants reported information about WRI they sustained between 2004 and 2006, including the activities they were…performing when injured. Investigators analyzed 248 injury incidents using qualitative and quantitative analysis. Results: Data were examined across OT and PT practice in general, and also by practice area. Manual therapy and transfers/lifts were associated with 54% of all injuries. Other activities associated with injury were distinct to practice area, for example: floor work in pediatrics; functional activities in acute care; patient falls in skilled nursing facilities; and motor vehicle activities in home care. Conclusions: Injury prevention activities must address transfers and manual therapy, but also must examine setting-specific activities influenced by environment and patient population.
Keywords: Occupational injury, therapy activities, pediatrics, skilled nursing facilities, rehabilitation, home health
Abstract: The purpose of this study was to identify safe patient handling (SPH) curricular content in accredited occupational therapy and occupational therapy assistant programs in the United States of America. A survey was emailed to 155 accredited occupational therapy and 137 accredited occupational therapy assistant programs. With a 39% response rate, most programs addressed SPH curricula by including lectures and lab-based experiences with gait belts, slide boards, and manual transfers while stressing 'safe' body mechanics. There…were limited responses regarding curricular-based hands-on experience, evaluation of sit-to-stand lifts, how to safely transfer bariatric persons, and information on "no-lift" policies. While occupational therapists have a central role in teaching SPH to caregivers, it is important to enhance SPH curricula to reduce exposure to musculoskeletal risk, thereby, increasing the health and safety of the occupational therapy workforce as well those whom the profession serves.
Abstract: Objective: Living a healthy lifestyle in order to manage stress encountered in the health care system is important for health care professionals. The purpose of this study was to increase healthy behaviors of undergraduate students in professional health care majors by introducing a health promotion intervention in a required course. Participants: The sample consisted of 201 undergraduate health professional students from nursing (NUR) (n=82, 40.8%), occupational therapy (OT) (n=72, 35.8%), and speech- language pathology…(SLP) (n=47, 23.4%). Methods: A pretest-posttest comparison group design was used. The NUR and OT students received a health promotion intervention to encourage a healthy lifestyle in a required course. SLP students served as a comparison group and did not receive content on self health promotion. Results: The comparison group (SLP) had significantly lower scores on the overall Health Promoting Lifestyle Profile II (HPLPII), physical activity and nutrition scales at posttest when compared to pretest. In contrast, students in the intervention group (NUR & OT) significantly increased in their health responsibility as measured on the HPLPII survey at the end of the semester. Conclusions: Infusing content on healthy behaviors in undergraduate curricula may better prepare professionals for living a healthy lifestyle.
Keywords: Health promotion, healthy behaviors, health professions, stress, health profession education, college students, self-care, burnout
Abstract: Objective: The aim of this study was to explore healthcare workers' opinions on workplace related health resources relevant to promotion of their health. Participants: 16 registered nurses and 19 assistant nurses, from a medical emergency ward at a medium sized hospital in the south of Sweden, participated in the study. Methods: Eight focus group interviews were conducted, the material was condensed and conventional qualitative content analysis was used to elicit and identify…patterns in the expressed opinions of the participants. Results: The analysis yielded four themes that were labelled the reward, the team, the mission and the context. An explanatory model was constructed consisting of concentric circles, with the reward at the core. The qualitative analysis also revealed two divergent patterns; some of the participants associated positive health with stability while others referred to flexibility. Conclusions: The results from this study have contributed to the body of knowledge regarding salutogenic health indicators in the field of work and health research in particular as well as in health promotion in general. The findings show that individuals can have diverse responses to any given work situation, and this should be taken into account before implementation of salutogenic health promotion programs.
Keywords: Positive occupational health psychology, health promotion, subjective experiences, nursing
Abstract: Objective: Job satisfaction is an important factor in the occupational lives of workers. In this study, the relationship between one-dimensional scale of job satisfaction and psychological wellbeing was evaluated. Participants: A total of 1,742 workers (1,191 men and 551 women) participated. Methods: 100-Point scale evaluating job satisfaction (0 [extremely dissatisfied] to 100 [extremely satisfied]) and the General Health Questionnaire, 12-item version (GHQ-12) evaluating psychological wellbeing were used. A…multiple regression analysis was then used, controlling for gender and age. The change in the GHQ-12 and job satisfaction scores after a two-year interval was also evaluated. Results: The mean age for the subjects was 42.2 years for the men and 36.2 years for the women. The GHQ-12 and job satisfaction scores were significantly correlated in each generation. The partial correlation coefficients between the changes in the two variables, controlling for age, were −0.395 for men and −0.435 for women (p< 0.001). A multiple regression analysis revealed that the 100-point job satisfaction score was associated with the GHQ-12 results (p< 0.001). The adjusted multiple correlation coefficient was 0.275. Conclusions: The 100-point scale, which is a simple and easy tool for evaluating job satisfaction, was significantly associated with psychological wellbeing as judged using the GHQ-12.
Keywords: Perceived job satisfaction, general health questionnaire 12 item version, aging
Abstract: Objective: To explore the relationship between managers' leadership and their health, by investigating what psychosocial conditions in the workplace managers experience as being important to their health, and how their health influences their leadership. Participants and methods: Semi-structured interviews with forty-two managers at different managerial levels in a large Swedish industrial production company. Results: Most managers felt their health was good, but many perceived their work as stressful. They said it was…important to their health that they did a good job and achieved results as expected, that conditions in the workplace enabled this achievement, and that their performance was acknowledged. In comparison to the other managerial levels, the first-line managers' work and health were especially dependent on such enabling conditions. The results also showed that the managers' health influenced their leadership, the quality of their work and the quality of their relationship with subordinates. Conclusion: Managers' leadership, health and their work conditions are reciprocally related to each other. A productive and healthy workplace is facilitated by focusing on managers' conditions for leadership, their health and their work conditions.
Keywords: Managerial levels, psychosocial work conditions, industrial production company
Abstract: Objective: Substantial evidence shows an association between musculoskeletal disorders (MSDs) and certain work-related physical factors. One of the jobs with known ergonomic hazards is working with video display terminals (VDTs). Redesign, ergonomic improvements, and education have generally been recommended as solutions for the prevention of musculoskeletal disorders. We designed this study to assess the effects of ergonomic training on the working postures of VDT users. Methods: In an intervention study, we assessed the impact…of ergonomic training on the ergonomic hazards and work postures in employees working with VDTs. Participants and their workstations were assessed by Rapid Upper Limb Assessment (RULA) method before and after training. Participants: 70 employees of an office, working with a VDT more than four hours per day entered the study. Results: The greatest compliance with OSHA workstation recommendations was seen with the monitor (21.4% of cases) and the least compliance with the one was the chair (10.0%). Mean RULA score before and after intervention were 5.90, and 5.07, respectively, and the difference was statistically significant (p < 0.001). Conclusions: It can be concluded from this study that training office ergonomics to the VDT users, even without changing work place components can significantly improve VDT users' behavior and ability to properly fit a workstation to him/herself.
Keywords: Office ergonomics, RULA, MSDs, ergonomic training
Abstract: Objective: Although respiratory device is an essential item to protect the wearer from hazardous gases and dust, it tends to increase heat load on the workers. The goal of this paper was to select the appropriate respiratory devices that can be used in a harsh weather under different work-loads. Methods: Sixteen young male participants participated in this study. Participants exercised on an ergometer bike in a laboratory at 30% and 50% of their physical…workloads, in temperature and humidity controlled environments (30°C and 40°C dry bulb temperatures with 50% and 90% Relative Humidity), while wearing six different respiratory devices. The effects on the participant's body functions (e.g., heart rate, aural canal temperature and blood pressure), and their subjective exertion ratings were measured. Results: Results proved that when wearing protective devices in hot environments, all physiological measures as well as exertion ratings were significantly increased. However, wearing half-face masks with two inlets exerted less stresses on the worker's physiological measures and subjective rating. Conclusions: This study recommended wearing half-face masks with two inlets to be used when performing tasks at hot environmental conditions.
Abstract: Objective: To develop a self-report alternative to the Work Environment Impact Scale (WEIS). Participants: First the novel instrument was used and evaluated by ten occupational therapists and 45~clients in primary health care. Then the instrument was used by 26~clients who participated in a rehabilitation programme in another primary health care district. Methods: The instrument was investigated in two steps. First content validity and utility were investigated through a questionnaire addressed to occupational…therapists and their clients respectively. The response distribution was calculated by frequencies. Internal consistency was investigated. In the second step, a revised version of the instrument was investigated for test-retest reliability and internal consistency. The test-retest reliability was calculated by weighted kappa. The internal consistency of the WEIS-SR was calculated by means of Cronbach's alpha. Results: In step one the content validity was good to moderately good, the utility was good, and the internal consistency was satisfactory (0.72). In step two the internal consistency was good (0.88/0.89) and the test-retest reliability was mostly good to moderate (0.35–0.78, median 0.61). Conclusions: The instrument will be further investigated in other populations and take into consideration additional psychometric properties such as sensitivity to change, predictive validity, and concurrent validity.
Keywords: Return to work, work environment, assessment, psychometric properties, MOHO