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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: BACKGROUND: A challenge facing stakeholders is the identification and translation of relevant high quality research to inform policy and practice. This study engaged academic and community stakeholders in conducting a best evidence-synthesis to enhance knowledge use. OBJECTIVES: To identify modifiable workplace disability risk and protective factors across common health conditions impacting work-related absence. METHODS: We searched MEDLINE, Embase, CINHAL, The Cochrane Library, PsycINFO, BusinessSourceComplete, and ABI/Inform from 2000 to 2011. Systematic…reviews that employed quantitative, qualitative, or mixed methods of work-focused population were considered for inclusion. Two or more independent reviewers reviewed titles only, titles and abstracts, and/or full articles when assessing eligibility for inclusion. Selected articles underwent methodological screening. RESULTS: The search strategy, expert input and grey literature identified 2,467 unique records from which 142 full text articles underwent comprehensive review. Twenty-seven systematic reviews met eligibility criteria. Modifiable work factors found to have consistent evidence across two or more health conditions included lack of social support, increased physical demands at work, job strain, lack of supervisory support, increased psychological demands, low job satisfaction, low worker control of job, and poor leadership quality. CONCLUSIONS: The active engagement of stakeholders led to greater understanding of relevance of the study findings for community stakeholders and appreciation of the mutual benefits of collaboration.
Abstract: Mental health claims in the workplace are rising, particularly those due to depression. Associated with this is an increase in disability costs for the employer and the disability insurer, but even more important is the human suffering that results. While treatments are available for the depression there is a gap in interventions that specifically target return-to-work preparation. This paper presents cognitive work hardening, a treatment intervention that can bridge this gap by addressing the unique functional…issues inherent in depression with a view to increasing return-to-work success. Cognitive work hardening applies the proven principles of classical work hardening (which has typically been applied to people with physical injuries) to the mental health domain. This paper explains how the occupational therapy principle of occupation and the core competency, enablement, are utilized and applied in cognitive work hardening. Key skills of the occupational therapist are also discussed. In addition, the paper considers the relationship of cognitive work hardening to recovery and mental illness, and the role it plays among workplace-based return-to-work interventions in the current movement toward non-clinical return-to-work interventions.
Abstract: OBJECTIVE: To introduce fixation disparity variance as an objective measure of visual discomfort. A higher variance in fixation disparity is indicative of more visual fatigue. This observation is based on the results from a study where we investigated how fixation disparity was affected by glare on a VDU. Participants. In total 16 subjects with normal vision participated in this study. METHOD: In a balanced repeated-measurement experiment, all subjects performed equal near-vision tasks. In addition…to the condition of no glare three controlled conditions of glare were used: direct light, indirect light, and desk luminary. After each condition, the fixation disparity was measured 15 times using a computerized fixation disparity test. RESULTS: The results showed that the average (mean) disparity was found to increase towards esophoric (crossed) with the adversity of the lighting conditions, but the differences were not significant. However, when analyzing the variation (standard deviation) within the 15 measurements and comparing these between conditions, we found that the direct light condition resulted in significantly higher variation compared to lighting condition of no glare and desk luminary lighting. CONCLUSION: Based on these findings, we argue that fixation disparity variance may be a useful objective measure of visual fatigue.
Abstract: OBJECTIVE: Employment rates are significantly lower among individuals with arthritis compared to a general population. There is, however, limited research about how men with arthritis perceive their ability to maintain working. The aim of this study was thus to explore their perception of this. PARTICIPANTS: Nine employed men with arthritis were purposively sampled. METHODS: Interviews were performed and were informed by the central concepts of the Model of Human Occupation. The Empirical Phenomenological Psychological method was modified and…used to analyze and interpret collected data. RESULTS: The findings showed that men with arthritis perceived a desire to work, adjusted their activity pattern, were aware of their own capabilities, had good work conditions, had environmental support and used effective medication to maintain their ability to work. CONCLUSIONS: The findings suggest that health care professionals can help men with arthritis to find strategies and a balance between recreation and work. Ultimately, this knowledge could guide health care professionals to target men needing interventions to prevent sick leave.
Keywords: Ability to work, empirical phenomenological psychological method (EPP), rheumatism, rheumatology, work ability
Abstract: OBJECTIVE: To determine if disability is a significant factor in increasing the likelihood of experiencing stress regarding the ability to pay for housing and healthy food. PARTICIPANTS: 24.6% (n=16206) of 65,960 adults who responded to the social context optional module of 2009–2010 Behavioral Risk Factor Surveillance System identified themselves as having a disability. Adults with disabilities reported that they experienced significantly more stress about having money to pay for housing and healthy…food than adults without disabilities. METHODS: This research was a quantitative study using a publicly available dataset. A series of logistic regressions were performed to determine the extent that disability affected the likelihood of stress about having enough money for housing and healthy food. RESULTS: Employed persons with a disability are 1.6 times and 1.9 times as likely as persons without a disability to experience stress about not having enough money to pay for housing and healthy food, respectively. Persons not employed with a disability are 1.56 times and 1.83 times as likely to experience stress about not having enough money to pay for housing and healthy food, respectively. For persons with a disability, being female, in poor health, without a health plan and having a lower income were also significant. Education and employment were not significant predictors of experiencing stress regarding money for food or housing. CONCLUSIONS: Having a disability is more predictive of experiencing stress about having enough money for housing and healthy food than employment, though variables such as low income and having a health plan, dependent on employment are significant. Therefore, strategies and policy recommendations to reduce stress by increasing employment and income for persons with disabilities were presented.
Abstract: OBJECTIVE: To evaluate musculoskeletal disorders (MSDs), associated factors and treatment among dentists over a one year period. METHOD: A total of 272 questionnaires were returned complete providing demographic information, details of the physical workload, location of pain in the body, and the treatment and prevention of MSDs. All data was coded for each of the parameters. The association between pain and each of the parameters was determined by parametric and non-parametric statistical tests (P < 0.05). PARTICIPANTS:…General and specialist dentists participated in the study. The sample set of dentists consisted of 205 (75.4%) generalists and 67 (24.6%) specialists. RESULTS: Seventy-five percent of the total cohort experienced MSDs. Female dentists complained of pain significantly more frequently than their male counterparts (p=0.018). Significantly higher rates of pain and MSDs are related to increased years of work (r=0.168, p =0.017) and less regular ergonomic exercise (p=0.002). Reported pain was most common in the shoulder (44.2%), neck (31.8%) and lower back (29.9%). Dentists who worked inclined had significantly more pain disorder than those who did not (p=0.013). In total 23.5% of dentists reduced working hours and 16.5% sought medical help. CONCLUSION: Pain was most commonly reported in the shoulder, neck and back. Physical workload is an important factor in MSDs. The impact of MSDs on the work and life of dentists demonstrates the need for increased knowledge of MSDs and the instigation of preventive strategies.
Keywords: Musculoskeletal pain, shoulder and neck disorders, dentistry, risk factors
Abstract: BACKGROUND: Designers and ergonomists occasionally must produce anthropometric models of workstations with only summary percentile data available regarding the intended users. Until now the only option available was adding or subtracting percentiles of the anthropometric elements, e.g. heights and widths, used in the model, despite the known resultant errors in the estimate of the percent of users accommodated. This paper introduces a new method, the Median Correlation Method (MCM) that reduces the error. OBJECTIVE:…Compare the relative accuracy of MCM to combining percentiles for anthropometric models comprised of all possible pairs of five anthropometric elements. Describe the mathematical basis of the greater accuracy of MCM. METHODS: MCM is described. 95th percentile accommodation percentiles are calculated for the sums and differences of all combinations of five anthropometric elements by combining percentiles and using MCM. The resulting estimates are compared with empirical values of the 95th percentiles, and the relative errors are reported. RESULTS: The MCM method is shown to be significantly more accurate than adding percentiles. MCM is demonstrated to have a mathematical advantage estimating accommodation relative to adding or subtracting percentiles. CONCLUSIONS: The MCM method should be used in preference to adding or subtracting percentiles when limited data prevent more sophisticated anthropometric models.
Abstract: OBJECTIVE: To investigate factors associated with work ability among nursing professionals. PARTICIPANTS: They comprised 514 nursing professionals (83.8% of the total number of workers) from a hospital in São Paulo, Brazil. METHODS: In 2009, we conducted a cross-sectional study that was a part of a 5-year planned cohort study initiated in 2008. We administered a comprehensive questionnaire to the participants in order to obtain data on their sociodemographic characteristics, lifestyles, and working conditions. The…questionnaire also contained the Brazilian versions of the following: the Job Stress Scale (JSS), Effort-Reward Imbalance (ERI) Questionnaire, Work-Related Activities That May Contribute To Job-Related Pain and/or Injury (WRAPI), and Work Ability Index (WAI). The results were analyzed using descriptive, bivariate, and multivariate linear regression analyses. RESULTS: On the WAI, 74.9% of the workers obtained a score of over 40 points (score range 7–49); the mean score was 42.3 points (SD=4.5). The final multivariate model showed that lower WAI scores were related to the work-related outcome, which was work injury, and the following individual characteristics and working conditions: body mass index (p=0.001), sex (female; p=0.002), sedentariness (p < 0.001), time in the profession (p=0.005), social support at work (p=0.003), effort-reward ratio (p=0.001), violence at work (p=0.005), WRAPI score (p < 0.001), and work injuries (yes; p=0.001). CONCLUSIONS: Various factors were associated with work ability. The results showed that a number of variables should be considered when planning and implementing actions to maintain or improve work ability among nursing professionals.
Keywords: Work stressors, psychosocial factors at work, worker's health, work ability
Abstract: BACKGROUND: Emergency room (ER) work includes dealing with situations of conflict and aggression. The diversity and unpredictability of these situations and the lack of pre-established procedures to guide workers in dealing with these phenomena affect and weaken their physical and mental health. OBJECTIVE: The purpose of the article is to learn about conflict and aggression at work and its impact on the workers in a hospital emergency room. METHOD: The method is…a transversal, exploratory, descriptive and observational study, carried out from September to November 2008, using direct observation procedures and interviews. PARTICIPANTS: Two hundred and eighty emergency room workers participated in the observations and eleven interviews were carried out with workers from several professional categories. RESULTS: The work process is marked by overload, individualization of responsibilities, time pressures and deadlines for making decision, little space for exchange and sharing, lack of support or guidance. The strong pressure to provide care quickly causes conflict and aggression among users and the different professional teams. These situations arise from problems in work organization and users in excess of the ER service capacity. CONCLUSION: The article recommends changes in the work process that can simultaneously improve both the quality of care for patients and provide protective measures for workers.
Keywords: Health care professionals, working conditions, mental health
Abstract: BACKGROUND: Studies involving the therapeutic nature of the work done by chemically dependent individuals undergoing treatment in therapeutic communities are scarce, not only in Brazil, but also in the international literature. OBJECTIVE: To clarify the role played by work as a therapeutic element for patients who are undergoing treatment in a drug-free therapeutic community setting in Brazil. Clients are free to choose their occupations during treatment, that exercise their creativity and their responsability for…their recovery. METHOD: The Biographical Method was employed in two case studies. CONCLUSIONS: The approach adopted by the community enabled clients to recognize how they became chemically dependent, as well as their possibilities for recovery. Clients expanded their interests and their daily activities that were once exclusively directed towards the consumption of drugs. Their personal development improved through their contact with reality through work activities, in the context of a therapeutic community. From there, clients were increasingly able to plan and execute life projects aimed at their full recovery.
Keywords: Chemical dependence, ergotherapy, occupation
Abstract: BACKGROUND: Individuals with different impairments are working in the formal and/or informal market despite physical and attitudinal barriers. To date, few studies have addressed this situation from the perspective of the individuals. OBJECTIVE: Apprehend factors that restrict work performance in the perspective of workers with impairments and identify the strategies employed and the difficulties faced. PARTICIPANTS: Individuals with impairment who exercised paid activities. METHODS: Thirty semi-structured interviews and eleven observations…of individuals in work activities. RESULTS: Limitations stemming from participants' disability and health status had an influence over their execution of tasks, but did not compromise work performance. Environmental factors that impacted as facilitators or barriers were: lack of preparation of colleagues, employers, education and rehabilitation systems; attitudes and coexistence; accessibility, implementation of land use policies, urban structures and transportation; products and technology; and distributive policies. Personal factors (upbringing, self-esteem, good mood, outgoingness, communicability, willpower, age and how the disability was acquired) also influenced participation at work. Important strategies included recognizing and sharing capabilities and needs, which minimized or eliminated difficulties at work. CONCLUSIONS: Workers with impairments developed effective strategies for dealing with adverse situations, which remained in the individual realm. Working with impairments is a complex experience that demands overcoming old paradigms.
Keywords: Persons with impairment, working conditions, occupational health, International Classification of Functioning, Disability and Health, personal narratives
Abstract: BACKGROUND: Participation in the workforce is one of the main social evaluations all individuals are subject to in modern society. Public policies supporting social justice for persons with disabilities have gained prominence in several nations in the last decades and it is critical to ensure that those who want to work are afforded the opportunity to do so. Meanwhile they remain under represented in the labor market within the contemporary world. OBJECTIVE: The purpose of this study was…to identify facilitators or barriers faced by people with disability within the workforce. PARTICIPANTS: Ten workers with disabilities from various companies and performing diverse professional job functions participated in semi-structured interviews. METHOD: The Discourse of the Collective Subject method was employed as a means to organize and analyze qualitative data of a verbal nature. RESULTS: Reasonable work conditions, adjustments, and accommodations facilitate performance and job retention. Social participation through employment leads to social recognition and the feeling of citizenship. On the other hand prejudice, unequal opportunities, workers' low educational attainment, and lack of training opportunities lead to employment exclusion. CONCLUSION: To include people with disabilities in the workforce, it is necessary to focus on attaining equal levels of education, an unbiased and inclusive process for entering the labor market, and continued management of disability issues within the workplace. Together, these elements create equal opportunities for workers with disabilities to advance in their careers, which in turn enables participation, social recognition and guaranties their rights as citizens.
Keywords: Worker with disability, labor force, supported employment, social participation, occupation