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