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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: Improving social support, and providing nature contact at work are potential health promoting workplace interventions. OBJECTIVE: The objective was to investigate whether nature contact at work is associated with employee’s health and participation, and to study whether the possible associations between nature contact and health can be explained by perceived organizational support. METHOD: Data were collected through a web-based, cross-sectional survey of employees in seven public and private office workplaces in Norway (n = 707, 40% response rate). Multiple linear and logistic regression analysis were performed on 565 participants fulfilling inclusion criteria. RESULTS: A…greater amount of indoor nature contact at work was significantly associated with less job stress (B = –0.18, CI = –0.318 to –0.042), fewer subjective health complaints (B = –0.278, CI = –0.445 to –0.112) and less sickness absence (B = –0.061, CI = –0.009 to –0.002). Perceived organizational support mediated the associations between indoor nature contact and job stress and sickness absence, and partly mediated the association with subjective health complaints. Outdoor nature contact showed no reliable association with the outcomes in this study. CONCLUSIONS: Extending nature contact in the physical work environment in offices, can add to the variety of possible health-promoting workplace interventions, primarily since it influences the social climate on the workplace.
Keywords: Workplace interventions, worksite health promotion, occupational health research, indoor plants, window view
Abstract: BACKGROUND: Mental health problems are a major cause for new disability grants in Norway. A variety of approaches in vocational rehabilitation is needed for this group. Green work is one such program that has been implemented at Norwegian care farms, which aims to promote health and support the transition from unemployment to working life. OBJECTIVE: To describe care farms in Norway and identify the presence of key components of such vocational programs. METHODS: In this case study, we used The Norwegian National Register of Care Farms to gain an overview of farms with vocational rehabilitation programs.…Data consisted of written information from five farms’ own web-site together with answers from a cross sectional questionnaire. Content about programs was systematically extracted by using national green work guidelines. RESULTS: Descriptions of care farm programs showed that key components outlined by the national guidelines for green work were present. These components were; (1) variety of work activities, (2) adaptation of work tasks, (3) the farmers’ support and supervision, (4) experiencing nature, (5) enhanced structure in everyday life. CONCLUSION: The description of vocational programs on care farms in relation to these key components, gives a thorough understanding of the content and organization of such programs.
Keywords: Care farming, green work, mental health problems, vocational rehabilitation, occupational rehabilitation, unemployment
Abstract: BACKGROUND: C are farming is a service developed at farms for promoting mental and physical health and is increasingly used in mental health rehabilitation in Norway. OBJECTIVE: This article aims to present a descriptive review of Norwegian intervention research on care farms that provide rehabilitation for people with mental health disorders. METHODS: This literature review applied a non-systematic search strategy: all articles in the field known to the authors were selected for inclusion. The selected studies were intervention studies that were conducted on farms in Norway, that used adult participants with mental health problems/disorders, and…that reported outcome measures related to mental health. The studies and articles presented quantitative and/or qualitative data. RESULTS: The findings from the published articles report improvements to mental health problems, such as depression, anxiety, perceived stress, positive affect, rumination, and self-efficacy. Qualitative data describe a variety of positive experiences, such as improved coping ability, increased social support, and appreciation of the care farm activity. CONCLUSION: Participating in interventions on care farms positively influences mental health. Care farming may therefore be used as a supplementary approach in mental health rehabilitation, as it offers meaningful and engaging occupations and social inclusion.
Keywords: Animal-assisted interventions, care farming, meaningful occupations, therapeutic horticulture
Abstract: BACKGROUND: There is an increasing interest in the possible healing factors connected to the presence of nature elements in health institutions. OBJECTIVE: The aim of the present study is to get a deeper understanding of how residents in a residential rehabilitation center experience the views through windows and the indoor plants, and whether and how the view and the plants can impact their recovery process. METHODS: In-depth individual and group interviews were conducted among 16 residents at a rehabilitation center in Norway. RESULTS: The participants said that the indoor plants and the view of…nature were pleasant to look at and elicited feelings of relaxation and positive emotions which contributed to opportunities for reflection and contemplation. They expressed a feeling of connectedness to nature: a feeling of wholeness and spirituality elicited by the nature elements. They also expressed that the presence of nature elements contributed to a sense of being taken care of. CONCLUSIONS: The nature elements, such as a view of nature or indoor plants, seem to enhance opportunities for reflection, feelings of meaningfulness and sense of being taken care of which may strengthen their feeling of well-being and make them more resilient to the stressors in life.
Abstract: BACKGROUND: Long-term sickness absence is a considerable health and economic problem in the industrialised world. Factors that might predict return to work (RTW) are therefore of interest. OBJECTIVE: To examine the impact of psychosocial work characteristics on RTW three months after the end of a RTW programme. METHODS: A cohort study of 251 sick-listed employees from 40 different treatment and rehabilitation services in Norway recruited from February to December 2012. The Job Content Questionnaire was used to gather information on the psychosocial work conditions. Full or partial RTW was measured three months after the end of…the RTW programme, using data from the national sickness absence register. Logistic regression analyses were performed to investigate the association between the psychosocial work characteristics and RTW. RESULTS: Having low psychological job demands (OR = 0.4, 95% CI: 0.2–0.9), high co-worker- (OR = 3.4, 95% CI: 1.5–5.8), and supervisor support (OR = 3.4, 95% CI: 1.6–7.3), and being in a low-strain job (low job demands and high control) (OR = 4.6, 95% CI: 1.1–18.6) were predictive of being in work three months after the end of the RTW programme, after adjusting for several potential prognostic factors. CONCLUSION: Interventions aimed at returning people to work might benefit from putting more emphasise on psychosocial work characteristics in the future.
Keywords: The rapid-RTW-study, sick leave, sickness absence, demand-control-support model, psychosocial work environment, job strain
Abstract: BACKGROUND: Mental health problems are leading causes for early and prolonged withdrawal from the workforce. Green work on care farms represents a prevocational training program intended to stimulate return to work for people with mental health problems. Research suggests that care farms may improve mental health, but there is still little knowledge of the subjective perspective of clients in green work programs. OBJECTIVE: To gain a deeper and broader understanding of the individual experiences of people with mental health problems participating in green work on care farms in Norway. METHODS: A hermeneutic phenomenological research design was…applied. Ten semi-structured interviews were conducted. The self-determination theory (SDT) was adapted to gain a deeper understanding of the themes that emerged in the analysis process of the interviews. RESULTS: Five main themes materialize describing participants’ experiences within the green work program. The main themes consist of (1) structure and flexibility, (2) understanding and acknowledgement, (3) guidance and positive feedback, (4) nature and animals, and (5) reflections on personal functioning and the future. CONCLUSION: The main themes identified indicate a high degree of autonomy support and need satisfaction within the care farm context, which according to SDT can facilitate good human functioning, and well-being.
Keywords: Mental health problems, prevocational rehabilitation, return to work
Abstract: BACKGROUND: Many people confronting mental health problems are excluded from participation in paid work. Supervisor engagement is essential for successful job placement. OBJECTIVE: To elicit supervisor perspectives on the challenges involved in fostering integration to support individuals with mental health problems (trainees) in their job placement at ordinary companies. METHODS: Explorative, qualitative designed study with a phenomenological approach, based on semi-structured interviews with 15 supervisors involved in job placements for a total of 105 trainees (mean 7, min-max. 1–30, SD 8). Data were analysed using qualitative content analysis. RESULTS: Superviors experience two interrelated dilemmas…concerning knowledge of the trainee and degree of preferential treatment. Challenges to obtaining successful integration were; motivational : 1) Supervisors previous experience with trainees encourages future engagement, 2) Developing a realistic picture of the situation, and 3) Disclosure and knowledge of mental health problems, and continuity challenges : 4) Sustaining trainee cooperation throughout the placement process, 5) Building and maintaining a good relationship between supervisor and trainee, and 6) Ensuring continuous cooperation with the social security system and other stakeholders. CONCLUSIONS: Supervisors experience relational dilemmas regarding pre-judgment, privacy and equality. Job placement seem to be maximized when the stakeholders are motivated and recognize that cooperation must be a continuous process.
Keywords: Work disability prevention, supported employment, sick leave, vocational rehabilitation, return to work
Abstract: BACKGROUND: Stress and mental fatigue are major health threats to employees in office-based occupations. Physical activity is widely used as a stress-management intervention for employees. Moreover, experiences in contact with nature have been shown to provide stress-reduction and restoration from mental fatigue. OBJECTIVES: In a pilot study designed as a randomized controlled trial we investigated the impact of a green-exercise intervention on psychological and physiological indicators of stress in municipality employees. METHODS: Fourteen employees (7 females and 7 males, 49±8 yrs) volunteered in an exercise-based intervention in workplace either outdoors in a green/nature area or…in an indoor exercise-setting. The intervention consisted of an information meeting and two exercise sessions, each including a biking bout and a circuit-strength sequence using elastic rubber bands (45-minutes, at about 55% of HR reserve, overall). Main outcomes were perceived environmental potential for restoration, affective state, blood pressure (BP) and cortisol awakening response (CAR AUCG and CAR AUCI ) and cortisol levels in serum. Measurements were taken at baseline and in concomitance with the exercise sessions. Furthermore, affective state and self-reported physical activity levels were measured over a 10-weeks follow-up period. RESULTS: Compared with the indoor group, the nature group reported higher environmental potential for restoration (p < 0.001) and Positive Affect (p < 0.01), along with improved CAR AUCI (p = 0.04) and, marginally, diastolic BP (p = 0.05). The nature group also reported higher ratings of Positive Affect at follow-up (p = 0.02). Differences at post-exercise were not found for any of the other components of affective state, systolic BP, CAR AUCG and cortisol levels measured in serum. CONCLUSIONS: Green-exercise at the workplace could be a profitable way to manage stress and induce restoration among employees. Further studies on larger samples are needed in order to improve the generalizability of the results.
Abstract: BACKGROUND: Care farming is an increasing part of multifunctional agriculture. Still there are few studies on how the farmers experience their working situation. OBJECTIVE: To describe care farmers’ relevant education, motivation, perceived support, involvement with participants, and perceived strain. We also wanted to investigate the possible relationship between different variables and level of perceived strain. METHODS: A total of 98 (67%) Norwegian care farmers answered a postal questionnaire in 2011 on demography, motivation, relevant education, involvement in participants, and 11 statements describing perceived strain of care farming. A sum-score of the 11 statements was constructed, and…a linear regression model was used to explore the relationships between total perceived strain and the other variables. RESULTS: Of the farmers 40% had relevant education. Their main motivation was economical (53%) or “idealistic” (47%). 80% reported that care farming had increased their quality of life. Still the majority experienced it to be socially demanding, and 26% did not receive support from professionals. Higher total perceived strain was found for men, low education, no perceived support, high degree of involvement, and less perceived functionality of participants. The model explained 40% of the variance in total perceived strain. CONCLUSION: More systematic cooperation and supervision from the social and health care system might be needed, in order to ensure a health promoting work situation for these care farmers.
Keywords: Care farming, Green care, multifunctional agriculture, work situation, strain
Abstract: BACKGROUND: Work-related Musculoskeletal Disorders (MSDs) affect the well-being of workers. Unfortunately, user requirements for design to reduce workplace risk factors for MSDs are not always effectively communicated to designers creating a mismatch between the user requirements and what is ultimately produced. OBJECTIVE: To understand the views of practitioners of design and ergonomics regarding tools for participatory design and features they would like to see in such tools. METHODS: An online questionnaire survey was conducted with a cohort of practitioners of ergonomics and design (n = 32). In-depth interviews were then conducted with a subset of these practitioners…(n = 8). To facilitate discussion, a prototype integrated design tool was developed and demonstrated to practitioners using a verbalized walkthrough approach. RESULTS: According to the results of the questionnaire survey, the majority (70%) believed an integrated approach to participatory design would help reduce work-related MSDs and suggested ways to achieve this, for example, through sharing design information. The interviews showed the majority (n = 7) valued being provided with guidance on design activities and ways to manage and present information. CONCLUSION: It is believed that an integrated approach to design in order to help reduce work-related MSDs is highly important and a provision to evaluate design solutions would be desirable for practitioners of design and ergonomics.
Abstract: BACKGROUND: In Canada and other countries, sickness-based absences among workers is an economic and sociological problem. Return-to-work (RTW) policy developed by both employer and worker’ representatives (that is, bipartite policy) is preferred to tackle this problem. OBJECTIVE: The intent was to examine how this bipartite agreed-upon RTW policy works from the perspective of occupational health professionals (those who deliver RTW services to workers with temporary or permanent disabilities) in a public healthcare organization in Canada. METHODS: In-depth interviews were held with 9 occupational health professionals and transcribed verbatim. A qualitative, social constructivist, analysis was completed.…RESULTS: The occupational health professionals experienced four main problems: 1) timing and content of physicians’ medical advice cannot be trusted as a basis for RTW plans; 2) legal status of the plans and thus needing workers’ consent and managers’ approval can create tension, conflict and delays; 3) limited input and thus little fruitful inference in transdisciplinary meetings at the workplace; and yet 4) the professionals can be called to account for plans. CONCLUSIONS: Bipartite representation in developing RTW policy does not entirely delete bottlenecks in executing the policy. Occupational health professionals should be offered more influence and their professionalism needs to be enhanced.
Abstract: BACKGROUND: Low back pain is a significant cause of lost workplace productivity. Identification of simple, safe, and effective treatment strategies that can be used in the workplace are needed. OBJECTIVE: To assess whether far-infrared therapy (FIR) can ameliorate chronic back pain in office workers with the hypothesis that back pain could be effectively treated while at work with minimal interruption to the normal working day. METHODS: In a cohort study, 50 subjects with low back pain of at least six months duration were recruited from a Florida corporation. The subjects were instructed to use a FIR…pad placed in their chairs in contact with the affected area while on the job over a 4 week period for at least 45 minutes a day during workdays. The FIR device used for the study was the Thermotex TTS Platinum Pad, a widely available FDA-registered medical device with preclinical data on its deep heating effects. The outcomes were assessed using subscales of the SF-36v2. RESULTS: Results showed statistically significant changes in 9 of 10 SF-36 subscales including both physical and mental components with a near significant improvement to General Health. There was progressive improvement each week in physical component and bodily pain scales. There were no reported adverse events. CONCLUSIONS: Use of site-specific FIR therapy over a four-week period in the workplace was associated with significant clinical improvements in pain and quality of life for office workers with previously refractory low back pain.
Keywords: Workers, chronic back pain, alternative back pain treatment, device, workplace wellness
Abstract: BACKGROUND: Core stability and flexibility, features of Pilates exercise, can reduce loads to the upper extremities. Reducing loads is essential to improve symptoms for individuals with lateral epicondylosis. Although Pilates exercise has gained popularity in healthy populations, it has not been studied for individuals with lateral epicondylosis. OBJECTIVE: The purpose of this study was to determine if adding Pilates-based intervention to standard occupational therapy intervention improved outcomes as measured by the Patient-Rated Tennis Elbow Evaluation (PRTEE) more than standard intervention for individuals with lateral epicondylosis. METHODS: Participants (N = 17) were randomized to the standard intervention group…or Pilates-based intervention group. All participants received standard intervention. The Pilates-based intervention group additionally completed abdominal strengthening, postural correction, and flexibility. RESULTS: For both groups, paired t -tests showed significantly improved PRTEE scores, 38.1 for the Pilates-based intervention group, and 22.9 for the standard intervention group. Paired t -test showed significantly improved provocative grip strength and pain for both groups. Independent t -tests showed no significant difference between groups in improved scores of PRTEE, pain, and provocative grip. CONCLUSIONS: Although the Pilates-based intervention group showed greater improvement in PRTEE outcome, provocative grip, and pain, scores were not significantly better than those of the standard intervention group, warranting further research.
Abstract: BACKGROUND: Previous research has suggested eliminating certain types of manual material handling (MMH) work by recommending specific arm angles and postures to avoid, such as arm flexion or abduction over 90°. MMH with arm flexion over 90° can require lifting objects as well as lowering objects. However, few studies have evaluated MMH work while lowering objects in detail. OBJECTIVE: This study investigated the effects of different lifting and lowering heights on upper arm, shoulder, and back muscle activity during a MMH task. METHODS: The participants performed a MMH task that involved stoop lowering and lifting. The…participants transferred the box to shelves positioned 30 cm in front of them under various conditions. Conditions 1 to 4 involved transferring the box to 1) ankle-, 2) knee-, 3) waist-, and 4) shoulder-high shelves, respectively. Surface electrodes were attached to the biceps brachii, upper trapezius, rhomboid minor, and L4 erector spinae. RESULTS: The activity of the biceps brachii was decreased significantly in Conditions 1 and 2 compared to Conditions 3 and 4. The upper trapezius activity was increased significantly in Conditions 1 and 4 compared to Conditions 2 and 3. The rhomboid minor activity increased significantly in Condition 1 compared to Conditions 2 to 4. The L4 erector spinae activity decreased significantly in Condition 1 compared to Conditions 2 to 4 CONCLUSIONS: A low-lowering MMH work could contribute to neck, shoulder, and back pain. Therefore, further studies must examine a height below-knee MMH work in detail.
Abstract: BACKGROUND: Since the mid-1990 s, Prevention through Design (PtD) has become increasingly prevalent in the built environment. The acceptance of PtD has largely been due to the removal or reduction of risks during the execution phase of construction projects. European States have had the added impetus of national legislation. OBJECTIVE: This paper analyzes the influence of European Union Directive 92/57/EEC on occupational safety and health injury prevention in the project design phase. METHODS: Qualitative methods comprised individual semi-structured interviews and focus groups with a panel of experts. Sixty individuals from construction and related professions (architects, engineers, constructors,…developers, and other construction experts) answered 17 key questions to establish national perceptions of the effectiveness of Directive 92/57/EEC in Spain and the United Kingdom (UK). RESULTS: The implementation of PtD in the project design phase in the UK is clearer since the regulations explicitly state the obligations of project designers as well as those of the coordinator. Interviews with Spanish experts show that, in Spain, the prevention culture is less frequently realized. CONCLUSIONS: The most significant differences between the European Directive and national regulations which influence PtD are linked to the Health and Safety Coordinator, and Health and Safety documents.
Keywords: Prevention through design (PtD), directive 92/57/EEC, occupational safety and health, construction
Abstract: BACKGROUND: There are many effective methods for decreasing the likelihood of repetitive strain injury (RSI) for those who work at a computer in an office environment. This study is focused on the highly repetitive task of interpreting seismic data. The skilled geoscientists who perform this work are very well compensated, and their work is vital to the success of the oil company. However, RSIs are still occurring in situations where effective methods of mitigating injuries have been successfully implemented and this has been occurring very frequently for geoscientists. This suggests that there are other elements contributing to the development of…these injuries and one element could be the software interaction design. However, it is difficult for software designers to determine this because most measures associated with muscle activity require expensive data collection methods. OBJECTIVE: This paper describes research conducted to determine if survey-based subjective measures might be used to assess the potential for RSI for software programs. METHODS: In laboratory and field settings, data were collected using three different survey instruments (NASA-Task Load Index, Latko’s Busiest Hand Activity Level Scale, and the Borg CR10 Rating of Perceived Exertion Scale) and conventional measures of muscle activity (sEMG). Correlations between the surveys and muscle activity were then calculated. RESULTS: For both the laboratory and the field, people were able to provide reliable self-report information related to their muscle activity. However, the effect sizes were not large. CONCLUSIONS: These results suggest that self-report tools could be utilized to identify software interaction designs related associated with risks of RSI.
Abstract: BACKGROUND: News coverage in popular media can shape public perspectives on occupational issues. Few studies exist concerning how occupational injury and fatality are represented in the news. OBJECTIVES: This study examined how injuries, fatalities and worker characteristics were represented in newspapers compared with official government statistics. It also examined what individuals or organizations were most often included by reporters to provide interpretations of injuries and fatalities. METHODS: Quantitative content analysis was used to examine 304 newspaper articles from between 2007 and 2012 representing the nine most populous cities in the province of Ontario, Canada. Government data…came from reports compiled by the Workplace Safety and Insurance Board (WSIB) of Ontario. RESULTS: Compared to workers’ compensation board records, physical characteristics of injuries and fatalities were skewed toward the acute traumatic. Women were dramatically underrepresented in newspaper articles. Age distributions were represented. Goods-producing, transportation and resource extraction occupations were overrepresented while services were underrepresented. Worker voices were largely absent in newspaper accounts compared with law enforcement, the State and management. CONCLUSIONS: How workplace injury and fatality are framed, and who contributes to these frames, serves to shape public interpretations of occupational injury and fatality and how occupational health and safety issues might be addressed in the future.
Keywords: Occupational injury, health and safety, worker participation, media, content analysis
Abstract: BACKGROUND: Unemployment is a very stressful experience that significantly impairs an individual’s perception of their overall wellbeing. Interaction between unemployment and physical health is complex. OBJECTIVE: To analyze how specific coping strategies and socio-demographic variables may influence the level of physical and mental health perceived by those searching for work at an employment centre in Catanzaro, Italy. METHODS: Participants completed a set of self-administrated questionnaires including a socio-demographic questionnaire, the Coping Inventory for Stressful Situations (CISS) and the SF-12 Health Survey (SF-12). A forward stepwise multiple regression analysis was used to ascertain those coping strategies significantly…associated with participants’ perceived health status. RESULTS: Complete documentation was received from 113 registered unemployed participants, (61 men and 52 women) giving a response rate of 45% . Physical health status was significantly and positively associated with age and task-oriented coping, while the perception of mental health was associated not only with age, but also by lower emotion-oriented coping and a low number of previous job losses. CONCLUSION: The perception of health status is reduced among unemployed. Age is the only socio demographic variable that influences the perception of health status. Adaptive Task-oriented coping strategies are related to better physical health perception, whereas Emotion-oriented coping makes people prone to poorer mental health perception.
Abstract: BACKGROUND: Impaired work ability is associated with work-related illnesses, early retirement and rising pension costs. OBJECTIVE: To investigate the association between work ability and fatigue in nursing workers. METHODS: Cross-sectional study conducted with 100 nursing workers from two inpatient units at a public teaching hospital in Sao Paulo, Brazil. The data were collected by means of a socio-demographic profile questionnaire, Work Ability Index (WAI) and Chalder Fatigue Scale. The data were analyzed by means of descriptive and analytical statistical methods, tests of association and multiple linear regression. RESULTS: The study population was mainly composed…of women (88% ), exhibited a high educational level (76% ), average age 39.4 years old (SD = 9.5) and 15 years of professional experience, on average. The average score on WAI was good (39.4 points, SD = 6.0) but surprisingly, 35% of the participants exhibited moderate to poor work ability. Fatigue was found in 52% of the participants. The score on WAI decreased in association with fatigue (p < 0.001) and longer length of work in the same workplace (p = 0.001), as well as among nursing technicians compared to nurses (p = 0.040). CONCLUSIONS: Fatigue, longer length of work in the same workplace and work category nursing technician were associated with decreased work ability, which emphasizes the need for investment in health and quality of work life.
Keywords: Occupational health, nursing staff, work organization, work conditions, workload