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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: Musculoskeletal complaints among housewives are very common around the world. In Bangladesh, although the majority of women are involved in various household activities, no studies were found related to musculoskeletal health and ergonomic risk factors for this work. OBJECTIVE: This study explored the prevalence of commonly affected body parts where the women experienced Musculoskeletal Symptoms (MSS), the disruption of normal activities due to the MSS, and the association of MSS with ergonomic physical risk…factors among women engaging in regular household activities in a rural village of Bangladesh. PARTICIPANTS: Participants were women aged 20–45 in a small village in Bangladesh who were involved in regular household activities for at least 5 hours a day for the past year. METHOD: A total of 73 women were found eligible though door-to-door home visits to determine the prevalence of MSS. Women who had already been diagnosed with any arthritic conditions like rheumatoid and osteoarthritis were excluded for the study. The Standardized Nordic Questionnaire (SNQ) was used to determine the prevalence of MSS. Forty-six women out of 73 who reported MSS in the past 12 months were voluntarily assessed using the Musculoskeletal Disorder (MSD) risk assessment to determine the association between physical risk factors and MSS. RESULTS: 68.49% (n=50) women reported having MSS during the last 12 months and 50.68% (n=37) of the respondents were prevented from normal daily activities due to MSS. Most commonly affected regions were upper and lower back, wrist, knees and elbows. Awkward posture, such as bending, lifting and working in squatting position, movements of repetition were associated with MSS in different body parts. CONCLUSION: The prevalence of MSS and the resultant disruption of regular activities among rural women indicate that ergonomic attention is needed to improve their well-being.
Abstract: BACKGROUND: Many sewing machine operators are working with high risk factors for musculoskeletal health in the garments industries in Bangladesh. OBJECTIVE: To identify the physical risk factors among sewing machine operators in a Bangladeshi garments factory. PARTICIPANTS: Sewing machine operators (327, 83% female), were evaluated. The mean age of the participants was 25.25 years. METHODS AND MATERIALS: Six ergonomic risk factors were determined using the Musculoskeletal Disorders risk assessment. Data…collection included measurements of sewing machine table and chair heights; this data was combined with information from informal interviews. RESULTS AND DISCUSSION: Significant ergonomic risk factors found included the combination of awkward postures of the neck and back, repetitive hand and arm movements, poor ergonomic workstations and prolonged working hours without adequate breaks; these risk factors resulted in musculoskeletal complaints, sick leave, and switching jobs. CONCLUSIONS: One aspect of improving worker health in garment factories includes addressing musculoskeletal risk factors through ergonomic interventions.
Abstract: BACKGROUND: There is a scarcity of evidence regarding musculoskeletal symptoms prevalence among metal workers at different worksites in Bangladesh. OBJECTIVE: To determine the prevalence of musculoskeletal symptoms and associated factors among metal workers in Dhaka, Bangladesh. METHOD: This cross-sectional study was performed in 5 out of 12 randomly selected metal tools manufacturing factories in Dhaka, Bangladesh. A total of 60 eligible participants (45 male and 15 female) were asked to complete the short Bengali version of…the Dutch Musculoskeletal Questionnaire. In addition, observations within the workplace were performed using a predesigned checklist for identifying ergonomic risk factors. RESULTS: Prevalence of musculoskeletal symptoms during the last 12 months preceding data collection was reportedly 85%. Body regions reported to be most affected were upper back and lower back, then the wrist. Socio-demographic factors were not found to be significantly associated with musculoskeletal symptoms. In contrast, awkward posture and repetitive movement were significantly related to reports of musculoskeletal symptoms for the last 12 months preceding data collection. CONCLUSION: Results conclude that there is a high reported prevalence of musculoskeletal symptoms among metal workers, calling for an action on prevention and promotion in the work environment.
Keywords: Occupational health and safety, socio-demographic and ergonomic risk factors
Abstract: BACKGROUND: The prevalence of MSS among office workers is high worldwide, having a significant effect on medical costs, absenteeism, and quality of life. In Bangladesh, there are many office workers but there is no data on the prevalence and impact of MSS. OBJECTIVE: The aim of this pilot study was to determine the prevalence and distribution of MSS among paper based office workers from one local office in order to determine whether or not…an ergonomic intervention is required and the focus of the intervention needed. METHODS: A cross sectional study was conducted among 200 paper based office workers using a proportional stratified random sample. The Standardized Nordic Questionnaire was used to determine the prevalence and distribution of MSS. Data were analyzed using SPSS version 16.0. RESULTS: The mean age of the respondents was 43.0 years with a mean of 12.0 years work experience. 76.0% (n=152) of the respondents reported having MSS during the last 12 months. MSS complaints were reported primarily in the lower back region. 40.5% (n=81) of the respondents reported interruption of their normal daily activities within the last 12 months reportedly due to MSS. CONCLUSION: The current study showed the high prevalence rate of MSS among office workers in one workplace in Bangladesh. This was a pilot study, but it suggests that there is likely a need for further study into office workers' work sites and work practices to prevent work related injuries.
Keywords: Activities of daily livings (ADLs), impact of musculoskeletal symptoms (MSS), future studies
Abstract: BACKGROUND: Physiotherapy and occupational therapy professionals are at high risk of developing occupational musculoskeletal injuries globally. Musculoskeletal pain is the most common problem. OBJECTIVE: To determine the extent of discomfort that physiotherapy and occupational therapy health professionals report while working at a physical rehabilitation centre. PARTICIPANTS: Physiotherapy and occupational therapy professionals which include both graduate and diploma physiotherapists and occupational therapists as well as physiotherapy and occupational therapy assistants.…METHODS: A self administered questionnaire (survey) was conducted on a convenient sample of 101 physiotherapy and occupational therapy personnel. RESULTS: The mean age of the 101 participants was 27.8 (± 4.5) years and most of the participants (62%) had less than 5 years of work experience. Ninety-five percent of the participants complained of work related pain. Most of the participants reported pain in the lower back (n=84) followed by upper back (n=71) and neck (n=66). Significant associations were found for pain in ankles/feet with age (p=0.05) and pain in neck with gender (p=0.01). CONCLUSION: Physiotherapy and occupational therapy professionals suffer from pain in relation to the work they do as therapists which may be due to non-practice of appropriate body mechanics. Mechanism to assess level of practice during dealing with patients may be introduced to enable corrective measures. Incentives should be considered for appropriate practice.
Abstract: BACKGROUND: Returning to work after spinal cord injury (SCI) is a complex process due to the nature of injury and its devastating effect on all aspects of patients. This case study report is based on a spinal cord injury centre of Bangladesh. OBJECTIVE: The evaluation examined vocational assessment process and vocational interest of persons with SCI undergoing rehabilitation program in the center. METHODS: Occupational Therapists were interviewed to understand the existing vocational assessment services. This…study also used data from 183 vocational assessment forms to find out the association of vocational interests and other demographic factors. RESULTS: The vocational assessment conducted to gathered information on the physical capacity of the patient and physical environment of patients living area only. The most preferred vocational interest was shop management 39%, and returning to previous job 38%. Vocational trades with the lowest level of interest were computer (2%) and electronics (3%), and 10% of patients at the time of assessment were undecided. A statistically significant association between interest to return to previous job and gender, age, occupation before injury and living area were found. CONCLUSION: Patients go through a complex process to adapt to a new life after experiencing SCI which is significantly influenced by the rehabilitation professionals around him/her. A comprehensive assessment including psychosocial information and therapist's expertise on facilitations making vocational decision based on the variables can optimize the rehabilitation outcome.
Abstract: BACKGROUND: The Community Based Rehabilitation (CBR) is a common approach to work with disable people to improve their quality of life by improving the level of productivity and integrating them into society. But the effectiveness of CBR varies by country to country. OBJECTIVE: The aim of the study was to find out whether CBR programs really improved the level of productivity among persons with physical disabilities. METHODS: A cross-sectional study was conducted among equal number of respondents (n=51)…from each CBR coverage and non-coverage areas from two different upazilla (sub-districts) located 40 km away from the capital city of Bangladesh. Respondents were selected purposively and data were collected by face to face interviews. Willer's (1994) version of the Community Integration Questionnaire (CIQ) was used to measure the level of productivity among adult with physical disabilities. RESULTS: The mean score of total productivity integration in CBR coverage and non-coverage areas were 4.3 ± 2.4 and 4.5 ± 2.2 respectively. This difference was statistically non-significant (p=0.602).The levels of productivity integration between CBR coverage and non-coverage areas varied only 2–4% (p=0.793). CONCLUSION: The mean score of productivity integration and levels of productivity were not different significantly in CBR coverage and non-coverage areas.
Keywords: Productivity integration, community integration, Person with Physical Disabilities (PWD), physical disability
Abstract: BACKGROUND: The Nine Hole Peg Test (NHPT) is a simple, quick assessment often used by occupational therapists to assess finger dexterity. OBJECTIVE: The purpose of this study was to standardize the NHPT in Bangladesh so Bangladeshi therapists can administer and interpret this test with relevant cultural norms. METHOD: This study includes an inter-rater reliability (IRR) study and a normative study with Bangladeshi participants. RESULTS: In the IRR study, four raters were placed into 6 teams of two to…establish reliability between individuals in each team. Intra-Class Correlation (ICC) results showed a high inter-rater reliability with ICC average ratings of 0.882–0.998 between individual raters of each team. Culturally relevant norms were developed for the NHPT using a sample of 180 participants (females, n=90 and males, n=90) ranging in age from 18 to 60 years. The data from the 1st trials were analyzed between age categories of both 5 and 10-year increments. Normative data was found to be clinically significant across collapsed age groups: 18–39, 40–49, and 50–60 years of age for each gender. CONCLUSION: These age categories were used to standardize the NHPT in Bangladesh, making it a culturally relevant finger dexterity test for the Bangladeshi population.
Abstract: BACKGROUND: The antecedents that contribute to health disparities in maternal child health populations begin before birth and extend into the early prenatal and gestational growth periods. Mothers and infants living in rural poverty in particular are at considerable risk for problems associated with reproductive health, including pregnancy complications and premature births. OBJECTIVE: The aim of this manuscript is thus two-fold, to describe the epidemiologic makeup of the community and the intervention model of the…Community Caring Collaborative. METHODS: Innovative models of early-integrated care for high-risk mothers and children are showing promise for long-term outcomes. They foster environments that enable mothers to trust health systems while maintaining a workforce of high functioning health workers who understand the mechanisms that underpin maternal and child health disparities. The Community Caring Collaborative in Washington County, Maine developed one such model that has made inroads in bridging such gaps. This manuscript explicates a case study of how the Community Caring Collaborative came into being and why it established the Bridging model of comprehensive care. The focus of this manuscript is thus two-fold, the community and the intervention model. RESULTS: The "bridging model" develops trust-based relationships between high-risk mothers with the health system and its multiple resources. Community members with advanced training provide the support and care linkages that are critical for family success. CONCLUSIONS: Innovative models of collaborative care impact the health of vulnerable mothers and their children working toward a marked decrease in health related disparities.
Abstract: BACKGROUND: Employment represents the key to independence for women, and equal opportunity has been an elusive goal. For women with substance dependence, employment is strongly linked to the ability to sustain recovery. Unfortunately, for postpartum mothers with substance use disorders, gender-based barriers are magnified. A case analysis is provided to illustrate the interaction of multiple barriers to employment success in one postpartum woman's experience. OBJECTIVE: To elucidate the complex factors involved…in return to employment for postpartum women being treated for substance use disorders. METHODS: A review of the current literature on employment, substance use, and the postpartum period was performed. Themes identified in the literature were applied to analyze a representative case. RESULTS: Postpartum women with substance use disorders face a variety of challenges to employment success. Lack of education and job skills are common barriers to successful employment of women in addiction recovery. These barriers may be complicated by emotional or logistical challenges, or related to external factors such as stigma and/or previous criminal history. CONCLUSIONS: Assessment of employment history, marketable skills, and barriers should be an essential component of substance abuse treatment programs. Professionals working to increase employment opportunities for postpartum women with substance use disorders should be particularly aware of the multiple barriers they face and integrate employment assessment and skills training into the early stages of treatment programs.
Keywords: Substance use disorder, postpartum, parenting, drug use
Abstract: BACKGROUND: Increasing research suggests breastfeeding has many benfeits to mothers and children, yet breastfeeding duration rates remain well below Healthy People 2020 objectives. In order to increase breastfeeding rates, the complex role change in becoming a breastfeeding mother deserves closer examination. OBJECTIVE: This pilot study sought to explore the daily routines and supports experienced by primiparous breastfeeding mothers with the objective of using this information to design interventions to promote breastfeeding…duration. METHODS: Surveys were conducted at 2–3, 6–8, and 10–12 weeks postpartum. Data were analyzed using quantitative and qualitative methods. PARTICIPANTS: Eleven primiparous mothers. RESULTS: None of the eleven mothers interviewed at 2–3 week had a daily routine; 5 out of 9 mothers described a 'hint of a routine' at 6–8 weeks, and 6 out of 7 mothers described an 'emerging routine' at 10–12 weeks. Despite wanting more support and better preparation, most mothers succeeded with exclusive breastfeeding for the 12-week period. CONCLUSIONS: These findings were viewed through the lens of non-linear dynamics and transition theory. Implications for occupational therapy and occupational science were discussed.
Keywords: Non-linear science, transition theory, Healthy People 2020
Abstract: BACKGROUND: The literature suggests that at least 25% of all children [18,19] and up to 80% of children with developmental disabilities  have some type of feeding and/or eating difficulty. Currently there is limited information in the literature related to mothers who are mothering young children with difficulties in the area of feeding and eating. Specifically there is little information available regarding how mothering a young child with difficulties in feeding and eating impacts participation in…the work of mothering. OBJECTIVE: This paper discusses a piece of the qualitative portion of a mixed methods study. The qualitative portion of the study sought to examine the lived experience of mothers who were mothering a young child with feeding concerns. PARTICIPANTS: Five women between the ages of 26 and 41 years of age agreed to participate in this portion of the study. All of the women were married and were mothering a child between 12 and 36 months experiencing concerns related to feeding. METHODS: Phenomenological methods were used to complete the qualitative portion of this study. Each woman participated in one interview in her own home that lasted between one and two hours. RESULTS: Five themes emerged from the data analysis, feeling supported, seeking support, the range of emotions/feelings, dealing with the system, and the complexity of feeding. Two of the themes are discussed in this paper in detail as they relate to maternal work. CONCLUSIONS: Data from this study were analyzed in relationship to maternal work. Findings highlight the difficulty of negotiating daily mealtime occupations and support the connection between mealtime occupations and maternal work as outlined by Ruddick .
Abstract: PURPOSE: Mothering work has been studied by social and occupational scientists, as well as a few occupational therapists. However, there remains a lack of in depth qualitative analysis that provides a trajectory view of a mother's experience, particularly after traumatic events involving their children. This study sought to further understand a mothering experience from a mothering work lens following the near-drowning experience of a child in South Florida. METHOD: Antenarratology is a relatively new…approach for analyzing qualitative data. It provides a way to understand the complexities of phenomena over a period of time from a more contextual approach. This method was used to analyze a mother's blog post injury of her child. This report introduces the method and its application to one mother's experience using a case study format. RESULTS: Analysis of data using antenarratology methodology revealed a variety of disparate, inconsistent and common threads, which is acceptable in antenarratological explorations. This more appropriately mirrors the variations of life that a mother's work experiences in child care work entail, particularly post injury.
Abstract: BACKGROUND: The Social Cognition and Interaction Training-Autism (SCIT-A) is a social cognition curriculum for young adults with autism developed at the University of North Carolina. This study seeks to further the use of SCIT-A as a tool for family centered practice. OBJECTIVE. This study explored the value of a complementary parent/caretaker support group on occupational performance of young adult children participating in the SCIT-A program. An interprofessional SCIT-A program for young adults with high…functioning autism (HFA) was examined for its effect on transition. PARTICIPANTS: The program included five parents/caregivers and three young adult males with HFA. Final data collection was performed on three parents/caregivers and one young adult with HFA. METHODS: A mixed methods approach utilized two focus groups for caregivers and young adults. Quantitative results were obtained from the young adult. RESULTS: This paper describes themes among caregivers which included: (1) swapping family stories; (2) experiencing an epiphany; (3) place-making; and (4) transformation. Results for the young adult are also presented. CONCLUSIONS: This pilot study suggests a positive impact and possible future trajectories of research and programming of social cognition during transition to adult occupations. The importance of support and participation of caretakers to facilitate transition is elucidated.
Keywords: Transition, social participation, autism, caretakers
Abstract: BACKGROUND: Mothering is a major occupational role for many women however the research to date tends to focus on the transition to parenthood and mothering young children. Missing from the literature is an exploration of mothering beyond the early years of a child's life. OBJECTIVE: This qualitative research study uses grounded theory methods to explore the experience of mothering typically developing emerging adult children. METHODS: In-depth semi structured interviews and a focus group…were conducted with 14 women between the ages of 47–63 years old with at least one child who was between the ages of 18–29 years old (an emerging adult). All of the participants were living in the Midwestern United States. The goal of this study is to explore how mothering experience changes and evolves over time. RESULTS: Findings presented here focus on the work of mothering emerging adult children and the themes include providing a listening ear, emotional and financial support, and worrying. CONCLUSIONS: The findings illuminate a beginning understanding of the work involved with mothering children at this stage and add to Ruddick's theories on maternal practice.
Keywords: Parenting, occupation, qualitative research, grounded theory, social construction
Abstract: BACKGROUND: The majority of American women juggle careers and the demands of mothering. The experiences of midlife mothers on the issues of work and motherhood are important to explore because birth rates for older women continue to rise in the United States and in other countries including the UK and Canada. OBJECTIVE: To present a unique viewpoint on work and mothering from the perspectives and experiences of older first-time mothers. METHODS: A…purposive sample of thirteen women aged 45–56 years old participated in two in-depth interviews. Findings emerged in the context of a larger hermeneutic phenomenological study that aimed to understand older first-time mothers' perceptions of health and mothering during the transition to menopause. RESULTS: A paradox emerged in which the realities of motherhood did not meet the women's expectations. They were surprised by the centrality of commitment they felt towards the child and voiced strong ideals about how to do mothering right that included making changes to work schedules to be more available to their children. CONCLUSION: Health care professionals should be aware of specific issues that exist for older first-time mothers including adjustments to work. This knowledge will inform the support, education and care provided for these women.
Keywords: Hermeneutic, mothering, older mothers, phenomenology, qualitative research
Abstract: Employees who are members of the "sandwich generation", those who are raising children and assisting older adult family members, are a population at risk for issues related to physical and emotional health, balancing work and family responsibilities, and taking care of themselves. This commentary examines their situation and challenges, some of the potential negative effects of these compounded stressors, and recommends strategies that employers, families, and the individuals themselves can use to create a sustainable…work/caregiving situation.
Keywords: Family caregiver, employee caregiver, eldercare
Abstract: The case is the personal perspective and reflection of a father and his daughter, each individually addressing five key aspects of the role of father, revealing a unique and fundamental family perspective.
Keywords: Fathering, influence of fathers, effects of parenting
Abstract: BACKGROUND: Intergenerational transmission of survivor syndrome places the health of family occupation of Chareidi second and third generation survivors of the Holocaust at risk. OBJECTIVE: The purpose of this phenomenological study was to describe the lived experience and capture the essence of family health from the perspective of this cultural group. METHODS: Guided by phenomenological research design, 5 participants were interviewed. They described their perception of the health of their families and…how experiences in Nazi death camps impacted their families' health. RESULTS: Family health is an experience of being together and doing together. Generational transmission of family health was disrupted by the Holocaust. Dysfunction exists in generations that were produced by the survivors. Daily effort is required to reverse the effects of the Holocaust and establish connections with subsequent generations. CONCLUSION: The essence of occupational therapy is described as "being before doing", which is the cornerstone of individual health and well-being; and in this case family health. This study investigates a cultural group who is experiencing intergenerational transmission of trauma that disrupts family health. Opportunities to examine family health in all settings and consider implications for interventions should be explored.
Keywords: Family occupation, occupational therapy, phenomenology, survivor syndrome
Abstract: BACKGROUND: Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereaved parents. Employed parents may need time away from work to deal with this loss. OBJECTIVE: The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereavement. METHODS: Critical discourse analysis was used to examine labour policies and practices related to employment leave for bereaved parents in Canada. Results were compared to international labour standards. RESULTS: Universally, employment policies provide only for the…practical issues of bereavement. Commonly, leave is three days, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by grief or the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policies efface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues. CONCLUSIONS: Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks and ceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences for which healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employee wellbeing, reintegration and workplace productivity.