Work - Volume 57, issue 2

Authors: Jacobs, Karen

Article Type: Editorial

DOI: 10.3233/WOR-172561

Citation: Work, vol. 57, no. 2, pp. 147-148, 2017

Authors: Kant, IJmert | van Amelsvoort, Ludovic G.P.M.

Article Type: Research Article

DOI: 10.3233/WOR-172550

Citation: Work, vol. 57, no. 2, pp. 149-151, 2017

Authors: van Amelsvoort, Ludovic G.P.M. | de Brouwer, Carin P.M. | Heerkens, Yvonne F. | Widdershoven, Guy A.M. | Kant, IJmert

Article Type: Research Article

Abstract: Given large changes in working conditions and society, occupational health care has to prioritize its efforts towards fostering health and functioning of workers and as such promote work participation. This requires that more emphasis is given on the application of biopsychological models in the care of workers. Although a biopsychological approach is often mentioned as essential part of occupational health care, it’s application is often hampered in practice, by practical barriers and lack of practical knowledge. This is illustrated by a study that uncovered facilitating and hindering factors in the implementation process of a preventive strategy, proven effective in reducing …the risk of long term sickness absence. To facilitate the use of biopsychological models in occupational health care, it is shown that setting up a training curriculum is possible, based on the International Classification of Functioning, Disability and Health (ICF) grafted on available training in evidence based practice skills is possible. Furthermore, there is a need for elaboration of the personal factors relevant for workers and the relevant work-related environmental factors to support practical application of ICF in occupational health care. A paradigm shift in occupational health care can facilitate widespread implementation of the biopsychosocial approach in occupational health and may stimulate occupational health professionals to further integrate this approach in their daily practice. Show more

Keywords: The International Classification of Functioning, Disability and Health (ICF), occupational health care education, implementation, screening, ICF contextual factors

DOI: 10.3233/WOR-172549

Citation: Work, vol. 57, no. 2, pp. 153-156, 2017

Authors: de Brouwer, Carin P.M. | Verdonk, Petra | van Amelsvoort, Ludovic G.P.M. | Jansen, Nicole W.H. | Kant, IJmert | Widdershoven, Guy A.M.

Article Type: Research Article

Abstract: BACKGROUND: Functioning including work participation, is an emerging challenge in occupational health. The prevention of long term sickness absence (LTSA) through a strategy involving screening and structured early consultation (preventive strategy) was proven effective and can address participation issues. Implementation of this strategy has proven difficult. OBJECTIVE: The aim of this study is to investigate the experiences of occupational physicians (OPs) delivering a structured early consultation to office workers, in order to enhance implementation of the strategy. METHODS: In this case study, a mixed method design was used. Interviews and surveys were conducted to obtain …an in-depth picture of OPs experiences. RESULTS: Factors hindering implementation in relation to the OPs were difficulties in communicating the risk of future sick leave, prioritization of other tasks, maintaining a reactive approach due to work pressure, preference for prevention on the level of the work environment, privacy issues related to labeling workers to have mental or psychosocial issues, and the biomedical model being the mental model in use. CONCLUSIONS: Implementation of the preventive strategy seems to require a more profound focus on the biopsychosocial approach. Training of relevant skills is important to achieve a focus on prevention and fostering health over the lifespan. Show more

Keywords: Process evaluation, case study, preventive strategy, occupational health, screening

DOI: 10.3233/WOR-172547

Citation: Work, vol. 57, no. 2, pp. 157-172, 2017

Authors: de Brouwer, Carin P.M. | van Amelsvoort, Ludovic G.P.M. | Heerkens, Yvonne F. | Widdershoven, Guy A.M. | Kant, IJmert

Article Type: Research Article

Abstract: BACKGROUND: This paper addresses the need for a paradigm shift from post-diagnosis tertiary care towards maintenance and promotion of health across the lifespan, for healthcare in general and in occupational healthcare specifically. It is based on the assumption that the realization of this paradigm shift may be facilitated by teaching (future) occupational health professionals to use the International Classification of Functioning, Disability and Health (ICF). OBJECTIVE: Describing the development of a an ICF based occupational health curriculum. METHODS: Grafting a training trajectory in the ICF for educating the biopsychosocial health paradigm, onto a training trajectory …in the Critical Appraisal of a Topic (CAT), a method for teaching evidence based practice skills. RESULTS: The development process of the training trajectories in the master program Work, Health, and Career at Maastricht University is described as an example of an intervention for shifting the paradigm in healthcare curricula. The expected results are a shift from the biomedical towards the biopsychosocial paradigm, a reductionist approach towards a more holistic view on cases, a reactive way of working towards a more proactive work style, and from using a merely quantifiable evidence base towards using a broad evidence base. CONCLUSIONS: Incorporating the biopsychosocial paradigm into the assessment and scientific reasoning skills of students is not only valuable in occupational healthcare but might be a valuable approach for all disciplines in healthcare for which contextual factors are important e.g. rehabilitation, psychiatry and nutritional science. Show more

Keywords: Biomedical model, biopsychosocial model, evidence based practice, (occupational) health professionals

DOI: 10.3233/WOR-172548

Citation: Work, vol. 57, no. 2, pp. 173-186, 2017

Authors: Heerkens, Yvonne F. | de Brouwer, Carin P.M. | Engels, Josephine A. | van der Gulden, Joost W.J. | Kant, IJmert

Article Type: Research Article

Abstract: BACKGROUND: Many work-related items are not included in the current classification of environmental factors from the International Classification of Functioning, Disability and Health (ICF). Furthermore, personal factors are not classified and the ICF only provides a very limited list of examples. These facts make the ICF less useful for occupational health care and for research in the field of occupation and health. OBJECTIVE: The objective of this discussion paper is to introduce an elaboration of contextual factors, focussing on factors that influence work participation. METHODS: During the last 12 years, we developed two concept lists …from the bottom up. These lists are based on our experiences in teaching and research, suggestions from students and other researchers, and factors found in the literature. In the fall of 2015 a scoping literature review was done to check for missing factors in these two concept lists. RESULTS: An elaboration of contextual factors, consisting of a list of work-related environmental factors and a list of personal factors. CONCLUSIONS: Important contextual factors that influence work participation are identified. Researchers, teachers, students, occupational and insurance physicians, allied health care professionals, employers, employees, and policy makers are invited to use the elaboration and to make suggestions for improvement. The elaboration and the suggestions received can be used in the ICF revision process. The development of an ICF ontology must be given priority, to give room to this elaboration, which will increase the applicability of the ICF and enable mapping with other terminologies and classifications. Show more

Keywords: Environmental factors, personal factors, work participation, work ability

DOI: 10.3233/WOR-172546

Citation: Work, vol. 57, no. 2, pp. 187-204, 2017

Authors: Gafni-Lachter, Liat | Admi, Hanna | Eilon, Yael | Lachter, Jesse

Article Type: Research Article

Abstract: BACKGROUND: Strikes are means to influence policies related to working conditions, yet raise ethical dilemmas for healthcare workers. Nurse strikes have become more prominent around the world. OBJECTIVE: To assess the change in Israeli nurses’ attitudes towards strikes in light of two physician strikes that have preceded a nursing strike. METHODS: An anonymous survey was administered once in 2000 (N  = 106) and again in 2011 (n  = 175) following 110 days of a physician strike, to assess nurses’ attitudes towards the strike and resulting ethical issues. RESULTS: A statistically significant change (p  < 0.05) between …administrations revealed that in 2011 more nurses identified striking as a legitimate mechanism, would strike under the same circumstances, and felt that collaboration with physicians persisted despite the strike. Additionally, an increasing number of nurses said that the suffering of patients due to the strike is somewhat or entirely justified, although they were faced with a difficult dilemma of loyalty to physician colleagues vs. patients. Nurses reported finding ways to mitigate the suffering of patients resulting from the strike. CONCLUSIONS: While patient-centered care remains nurses’ first and foremost priority, findings indicate an increasing support of collective bargaining and strike to promote working conditions related to professional and public health agendas. Show more

Keywords: Advocacy, ethics, public health

DOI: 10.3233/WOR-172560

Citation: Work, vol. 57, no. 2, pp. 205-210, 2017

Authors: AL-Rammah, Tamader Y. | Aloufi, Areej S. | Algaeed, Saffana K. | Alogail, Noura S.

Article Type: Research Article

Abstract: BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) have a significant effect on the psychological and physical function of the sonographer. OBJECTIVE: This study is concerned about finding the prevalence of WRMSDs among sonographers in the Kingdom of Saudi Arabia and assessing how to improve future practices and develop guidelines for safe, pain-free ultrasound departments. METHODS: A survey was distributed to sonographers working in major hospitals in Riyadh, Saudi Arabia (n  = 100, 83% response rate). The questionnaire focused on workload and ergonomics, pain existence and history, and the level of the sonographers’ awareness of prevention measures and best …practices. Ethical approval was obtained from a local Institutional Review Board. RESULTS: Eighty-four percent of respondents suffer from pain they associated with their ultrasound practice. The shoulder, back, neck and right hand were the main symptomatic body areas. Low levels of awareness about best practices and safety measures were revealed. There was a strong correlation between the degree of pain suffered and the years of practice, the number of patients scanned per day, and movements during the exam. CONCLUSION: Implementing standards and guidelines for best ultrasound practices is needed to develop better and safer ultrasound departments in Saudi hospitals for every practitioner. Show more

Keywords: Ultrasound, awareness, ergonomics

DOI: 10.3233/WOR-172558

Citation: Work, vol. 57, no. 2, pp. 211-219, 2017

Authors: van Biljon, Hester | du Toit, Sanetta H.J. | Masango, July | Casteleijn, Daleen

Article Type: Research Article

Abstract: BACKGROUND: Occupational therapy clinicians working in South Africa’s public healthcare had views on what patients thought about their vocational rehabilitation services that were based on anecdotal evidence. However evidence-based practice requires more than that. Reliable information is important in patient-centred practice and in the assessment of service quality. OBJECTIVE: Clinical occupational therapists used the convergent interviewing technique to explore patients’ views of the vocational rehabilitation services on offer in public hospitals. METHOD: An Action Learning Action Research (ALAR) approach was used to explore the vocational rehabilitation services occupational therapy clinicians provided over a two week …period in three settings. RESULTS: The majority (96%) of patients interviewed were not aware that occupational therapists offered vocational rehabilitation services. The convergent interview technique allowed continued unrestricted discussion of their vocational rehabilitation concerns and provided evidence that patients had significant concerns about work. Critical reflection on the interview experience and technique indicated that therapists were in favour of using convergent interviewing to obtain their patients views about the services offered. Therapists found the convergent interview technique easy to apply in clinical practice. CONCLUSION: Establishing patients’ views of a clinical service have multiple values. However it is meaningless unless clinicians use the knowledge to improve service delivery to the patients who provided the views. Convergent interviewing was a valuable technique for occupational therapy clinicians to incorporate patients’ views of their services into service development. Show more

Keywords: Quality assurance, public healthcare, clinical practice, vocational rehabilitation, ALAR

DOI: 10.3233/WOR-172557

Citation: Work, vol. 57, no. 2, pp. 221-232, 2017

Authors: Joshi, Anurag | Kiran, Ravi | Sah, Ash Narayan

Article Type: Research Article

Abstract: BACKGROUND: This paper envelops the notion of yogic breathing and its applications as one of the techniques for stress management through regulation of skin conductivity among Indian engineering students. Stress perturbs the normal physiological or psychological functioning of an individual. Thus, it is extremely vital to manage stress. OBJECTIVE: To explore the consequence of yogic breathing on skin conductivity using galvanic skin response sensor meter (GSRSM) on engineering students, of different universities. METHODS: The study uses stratified random sampling technique for the experimental study undertaken to measure skin conductivity. 471 Engineering students, in the age …group of 18–22 years who gave informed written consent were screened, of which 71 (15%) dropped out and 400 students (84.9%) completed the study. The GSRSM was used to record skin conductivity (pre and post) among experimental (n  = 200) and Control group (n  = 200) each comprising of 52 females (26%) and 148 males (74%). The Experimental group underwent yogic breathing whereas the Control group did not do so. RESULTS: The experimental group reported reduction in mean value in skin conductivity after deep breathing for the time period (t  = 300 sec) as compared to the control group, and this was significant (p  < 0.01 and p  < 0.05). CONCLUSION: It is recommended that, this uncomplicated and yet extremely effectual ancient technique of yogic breathing could be included in core curriculum to reduce and manage stress among engineering students. The paper thus highlights the use of yogic technique as an effective mode for Stress Management amongst Indian Engineering students. Show more

Keywords: Engineering students, yogic breathing, tumbling stress, GSR sensor meter, skin conductivity, z-test

DOI: 10.3233/WOR-172553

Citation: Work, vol. 57, no. 2, pp. 233-243, 2017

Authors: Stergiou-Kita, Mary | Grigorovich, Alisa | Damianakis, Thecla | Le Dorze, Guylaine | David, Christine | Lemsky, Carolyn | Hebert, Debbie

Article Type: Research Article

Abstract: BACKGROUND: Misperceptions regarding persons with brain injuries (PWBI) can lead to stigmatization, workplace discrimination and, in turn, influence PWBIs full vocational integration. OBJECTIVE: In this study we explored how stigma may influence return-to-work processes, experiences of stigma and discrimination at the workplace for persons with (moderate to severe) brain injuries, and strategies that can be employed to manage disclosure. METHODS: Exploratory qualitative study; used in-depth interviews and an inductive thematic analytical approach in data analysis. Ten PWBI and five employment service providers participated. PWBI discussed their work experiences, relationships with supervisors and co-workers and experiences …of stigma and/or discrimination at work. Employment service providers discussed their perceptions regarding PWBI’s rights and abilities to work, reported incidents of workplace discrimination, and how issues related to stigma, discrimination and disclosure are managed. RESULTS: Three themes were identified: i) public, employer and provider knowledge about brain injury and beliefs about PWBI; ii) incidents of workplace discrimination; iii) disclosure. Misperceptions regarding PWBI persist amongst the public and employers. Incidents of workplace discrimination included social exclusion at the workplace, hiring discrimination, denial of promotion/demotion, harassment, and failure to provide reasonable accommodations. Disclosure decisions required careful consideration of PWBI needs, the type of information that should be shared, and the context in which that information is shared. CONCLUSIONS: Public understanding about PWBI remains limited. PWBI require further assistance to manage disclosure and incidents of workplace discrimination. Show more

Keywords: Head injury, brain injury, work, stigma, workplace discrimination

DOI: 10.3233/WOR-172556

Citation: Work, vol. 57, no. 2, pp. 245-258, 2017

Authors: Harrod, Molly | Miller, Erin M. | Henry, Jennifer | Zivin, Kara

Article Type: Research Article

Abstract: BACKGROUND: Ensuring Veteran employment needs are met is a top priority for the Department of Veteran Affairs and the United States government. However, Veterans, especially those with mental health disorders, continue to encounter difficulties when employed. While many employment related programs offer numerous services aimed at helping Veterans gain employment, their ability to maintain long-term employment remains unknown. OBJECTIVE: The objective of this study was to understand factors that affect the ability of Veterans with mental health disorders to maintain long-term employment. METHODS: An exploratory, qualitative study design consisting of semi-structured interviews with 10 Veterans …was performed. Inductive thematic analysis was performed to identify salient themes. RESULTS: We found that participants’ symptoms manifested themselves within the workplace affecting their ability to maintain employment, participants felt as if they had been demoted from what they did in the military, and they felt unable to relate to civilian co-workers. Strategies that helped some transition into the civilian workforce were also identified. CONCLUSIONS: A better understanding of the difficulties some Veterans face when trying to maintain employment is needed. Our findings suggest that increasing awareness of existing programs and ensuring that services provide resources and skills that help Veterans maintain long-term employment is critical. Show more

Keywords: Long-term employment, mental health, reintegration

DOI: 10.3233/WOR-172551

Citation: Work, vol. 57, no. 2, pp. 259-268, 2017

Authors: Runeson-Broberg, Roma | du Prel, Jean-Baptist | Westerholm, Peter | Nordin, Maria | Knutsson, Anders | Alfredsson, Lars | Fahlén, Göran | Peter, Richard

Article Type: Research Article

Abstract: BACKGROUND: In aging societies, zest for work may be pivotal when deciding to stay occupationally active longer. Psychosocial work stress is a prevalent public health problem and may have an impact on zest for work. Work over-commitment (WOC) is a personal coping strategy for work stress with excessive striving and a health risk. However, the long-term effect of WOC on zest for work is poorly understood. OBJECTIVE: To investigate the age-related associations of work over-commitment with zest for work. METHODS: During 1996–1998 and 2000–2003, predominantly industrial workers (n  = 2940) participated in the WOLF-Norrland study and …responded to a questionnaire referring to socio-demographics, WOC, zest for work, effort-reward imbalance proxies, and mental health. Age-adjusted multiple logistic regressions were performed with original and imputed datasets. RESULTS: Cross-sectionally, work overcommitted middle-aged employees had an increased prevalence of poor zest for work compared to their contemporaries without WOC (OR: 3.74 [95%-CI 2.19; 6.40]). However, in a longitudinal analysis associations between onset of ‘poor zest for work’ and the WOC subscales ‘need for approval’ (OR: 3.29 [95%-CI 1.04; 10.37]) and ‘inability to withdraw from work’ (OR: 5.14 [95%-CI 1.32; 20.03]) were observed. CONCLUSION: The longitudinal findings among older employees could be relevant regarding the expected need to remain occupationally active longer. Show more

Keywords: Work stress, WOC, ERI, coping

DOI: 10.3233/WOR-172555

Citation: Work, vol. 57, no. 2, pp. 269-279, 2017

Authors: Milner, A. | Witt, K. | Maheen, H. | LaMontagne, A.D.

Article Type: Research Article

Abstract: BACKGROUND: Emergency and protective services personnel (e.g., police, ambulance, fire-fighters, defence, prison and security officers) report elevated levels of job stress and health problems. While population-level research is lacking, there has been some research suggesting suicide rates may be elevated in emergency and protective services. OBJECTIVES: This paper compares suicide rates between emergency and protective services occupational groups over a 12-year period (2001–2012) in Australia. METHOD: Labour force data was obtained from the 2006 Australian Census. Suicide data was obtained from the National Coroners Information System (NCIS). Negative binomial regression was used to estimate the …association between suicide and employment as an emergency or protective service worker (including prison and security officers) over the period 2001–2012, as compared to all other occupations. Information on suicide method was extracted from the NCIS. RESULTS: The age-adjusted suicide rate across all emergency and protective service workers was 22.4 (95% CI 19.5 to 25.2) per 100,000 in males and 7.8 in females (95% CI 4.6 to 11.00), compared to 15.5 per 100,000 (95% CI 15.2 to 15.9) for males and 3.4 (95% CI 3.2 to 3.6) for females in other occupations. The highest risk by subgroup was observed among those employed in the defence force, prison officers, and ambulance personnel. The major method of death for all occupational groups was hanging. CONCLUSIONS: Our results clearly highlight the need for suicide prevention among emergency and protective service occupations. Show more

Keywords: Intentional self-harm, emergency service worker, police, ambulance, fire-fighter, military

DOI: 10.3233/WOR-172554

Citation: Work, vol. 57, no. 2, pp. 281-287, 2017

Authors: Sinakhone, Joyce K. | Hunter, Bronwyn A. | Jason, Leonard A.

Article Type: Research Article

Abstract: BACKGROUND: Women in metropolitan areas have lower employment participation and employment rates than men. Although women face multiple challenges in the labor market, those who have a history of substance use and are abstinent may have a greater disadvantage in obtaining viable employment opportunities due to factors associated with substance use. No research to date has examined employment experiences among women in recovery from substance use. OBJECTIVE: This study examined employment characteristics and experiences of women who had a history of substance use and lived in sober-living environments in urban areas. METHOD: Data were collected …through telephone interviews to sober living homes that were located in 20 urban areas. RESULTS: Themes identified through thematic analysis included employment challenges, the importance of work to substance abuse recovery, job satisfaction, employment aspirations, and employment support in the sober living home. CONCLUSION: Employment is important to women in substance abuse recovery, not only as a means for financial support, but also as a life priority. The results highlight how employer scheduling practices, low-level positions, and lack of employment supports impact recovery. Findings provide insight into the need for employment support services, including employer education and flexible policies for women in recovery. Show more

Keywords: Oxford House, recovery homes, addiction, employment

DOI: 10.3233/WOR-172552

Citation: Work, vol. 57, no. 2, pp. 289-295, 2017

Authors: Taib, Mohd Firdaus Mohd | Bahn, Sangwoo | Yun, Myung Hwan | Taib, Mohd Syukri Mohd

Article Type: Research Article

Abstract: BACKGROUND: Musculoskeletal disorders (MSDs) have been recognized as one of the main occupational health problems for dentists. Many studies have suggested that dentists experience work-related pain or discomfort in the neck, shoulder, and back, as well as in other parts of the body. OBJECTIVE: This study aimed to examine the relationship between specific physical and psychosocial factors and/or ergonomic conditions on MSD symptoms among dentists in Malaysia. METHODS: A group of 85 dentists was asked to complete a questionnaire to determine whether their complaints were related to physical and psychosocial factors and/or ergonomic conditions in …their practices. RESULTS: Among the nine reviewed body areas, the shoulders were most often affected by symptoms of MSDs (92.7%). Moreover, MSDs of the neck and upper back were most likely to prevent these practitioners from engaging in normal activities (32.9%). In general, no significant differences were found in the prevalence of MSD symptoms in relation to gender, age, body mass index, years in practice, number of patients, and frequency of breaks. CONCLUSIONS: Our results were consistent with those reported in other studies that focused on MSD problems among dentists in other countries. To reduce the prevalence of MSDs, more attention should be paid to instituting ergonomically sensible approaches in the dental practice setting. Show more

Keywords: Surveys, Nordic, stress, dentistry, ergonomics

DOI: 10.3233/WOR-172559

Citation: Work, vol. 57, no. 2, pp. 297-308, 2017