Work - Volume 65, issue 2

Authors: Jacobs, Karen

Article Type: Editorial

DOI: 10.3233/WOR-203098

Citation: Work, vol. 65, no. 2, pp. 231-232, 2020

Authors: Synovec, Caitlin E.

Article Type: Editorial

DOI: 10.3233/WOR-203099

Citation: Work, vol. 65, no. 2, pp. 233-234, 2020

Authors: Synovec, Caitlin E. | Aceituno, Laura

Article Type: Research Article

Abstract: BACKGROUND: Populations of those experiencing homelessness in the United States expand beyond those living in shelters and on the streets. Many individuals living in poverty experience housing instability, as well as refugee populations who experience deprivation of social resources due to displacement. These populations are significantly affected by social determinants of health (SDOH). OBJECTIVE: A current policy and literature review was completed to assess prominent SDOH impacting unstably housed populations in the United States, including refugees, encountered in occupational therapy practice. Review of evidence-based practice to address SDOH was completed to provide recommendations for practitioners across healthcare settings. …RESULTS: A review of policy and its impact on those experiencing housing instability or recently resettled identifies several significant barriers to full occupational performance and health management. Several specific occupational therapy interventions exist to address these barriers and are in alignment with current practice. CONCLUSION: Occupational therapy practitioners across practice settings should consider how current housing status and social determinants of health may impact their clients’ occupational performance and ability to manage health conditions. Show more

Keywords: Homelessness, poverty, refugee

DOI: 10.3233/WOR-203074

Citation: Work, vol. 65, no. 2, pp. 235-246, 2020

Authors: Van Oss, Tracy | Duch, Felicia | Frank, Sydney | Laganella, Gina

Article Type: Research Article

Abstract: BACKGROUND: Homelessness can impact society and individuals in many ways. OBJECTIVE: The purpose of this project was to examine the current occupation-based needs and services among persons experiencing homelessness (PEH) in a major city. METHODS: Researchers conducted semi-structured interviews with eight PEH residing in a homeless shelter. Three questions were asked of each participant: What daily personal activities have been most impacted since undergoing homelessness? Which services have been most helpful to you in overcoming homelessness? What other services might you find helpful to individuals experiencing housing insecurity? Researchers also gathered qualitative data utilizing a Photovoice …component in which twelve PEH had the opportunity to photograph one object and provide a quote associated with the meaningful object. RESULTS: Under-addressed areas of occupation, services received, and services requested were identified. Findings suggest that areas of occupation most impacted by homelessness include instrumental activities of daily living (IADLs), activities of daily living (ADLs), leisure, social participation, and rest and sleep. Services received included case management and often met basic self-care needs of PEH. Services requested included group therapy, restructuring of the shelter to support individualization, and staff training. CONCLUSIONS: Occupational therapy practitioners have the skill set to assess needed services among PEH. Meaningful objects captured by the clients via Photovoice may relate to past, present and future satisfaction despite being homeless. Show more

Keywords: Persons experiencing homelessness, occupational therapy

DOI: 10.3233/WOR-203076

Citation: Work, vol. 65, no. 2, pp. 247-255, 2020

Authors: Van Oss, Tracy | Barnes, Sydney | Carmona, Christina | Dobranski, Katelyn | Duffy, Catherine | Latella, Kristy | Shaw, Stephanie

Article Type: Research Article

Abstract: BACKGROUND: Graduate occupational therapy students collaborated with an Area Health Education Center (AHEC) to address occupational therapy’s role in intervening for individuals who are homeless. OBJECTIVE: The purpose was to provide educational resources on specific needs related to health and wellbeing to individuals who are homeless. METHODS: A variety of methods were used to gather information on common needs of the homeless population related to health and wellbeing, community integration, and development of routines. Initial data was collected through the use of a needs assessment for nine participants with thirteen questions followed with a weekly visit …to a homeless shelter. The weekly visits allowed the students to build rapport and trust with the residents to gain an understanding of individual perspectives and barriers to occupation. RESULTS: The students worked with residents how to best access community based resources and services related to occupational needs. Specific needs were identified, and further resources were provided to support community integration, independent living, and self-management. CONCLUSIONS: Preliminary findings provided a basic understanding of the foundational needs of individuals to be used to support future research linking occupational therapy to the homeless population to achieve individual goals, improve health and wellbeing, and enhance life skills management. Show more

Keywords: Occupational therapy, occupational needs, occupation

DOI: 10.3233/WOR-203077

Citation: Work, vol. 65, no. 2, pp. 257-263, 2020

Authors: Cavanaugh, Katherine

Article Type: Research Article

Abstract: Experiential and situational learning assert that learning is an ongoing process, in which the learner develops skills with in a supportive context. Consumer governance within health care settings allows consumers the opportunity to learn skills within a supportive space, and informs agencies regarding the consumer experience.

Keywords: Homelessness, communities, social support, consumer advisory

DOI: 10.3233/WOR-203078

Citation: Work, vol. 65, no. 2, pp. 265-269, 2020

Authors: Lambdin-Pattavina, Carol A. | Desiderio, Kori | Gilmore, Rebecca | Manohar, Basmatee

Article Type: Research Article

Abstract: BACKGROUND: Individuals experiencing homelessness endure occupational injustices in the form of marginalization and deprivation at higher rates than their counterparts who are not experiencing homelessness. This population’s expressed interests, needs, and desires are frequently ignored or unsolicited by a system of care that continues to exercise power over this fragile and underserved group. Marginalization and deprivation can lead to disempowerment. Few studies have been conducted that explore the perceptions of empowerment by those experiencing homelessness. Providing a “space” for the voice of those experiencing homelessness to be heard can promote occupational justice as an outcome of occupational therapy intervention. …OBJECTIVE: This pilot research sought to explore perceptions of empowerment by attendees of a day shelter for those experiencing homelessness. METHODS: Researchers used an Appreciative Inquiry approach to elicit responses to the question, “For those experiencing homelessness who attend a day shelter, what are their perceptions of how the shelter environment supports empowerment? ” This qualitative approach promotes and maintains focus on positivity and inclusivity with respect to the change process from solution identification to maintenance of identified changes. Shelter attendees participated in one of three focus groups. Based upon qualitative analysis of the data, environmental enhancements were made by the researchers and post-environmental enhancement surveys collected data related to perceptions of those enhancements to promote empowerment. RESULTS: Six themes emerged from the data and pointed to both internal and external factors that are perceived to impact empowerment. CONCLUSION: Results of this study can be used by occupational therapy practitioners to support and develop inclusive and empowerment-focused approaches for those experiencing homelessness. Show more

Keywords: Occupation, justice, empowerment

DOI: 10.3233/WOR-203079

Citation: Work, vol. 65, no. 2, pp. 271-283, 2020

Authors: Synovec, Caitlin E. | Berry, Sean

Article Type: Research Article

Abstract: BACKGROUND: Brain injury has been recently understood to be a common occurrence among adults experiencing homelessness, resulting in the need for modifications to clinical practice in agencies serving this population. OBJECTIVE: A health care agency for adults experiencing homelessness initiated a pilot training for mental health providers to address the issues of brain injury. METHODS: Providers attended eight training sessions which focused on: screening for a history of brain injury, treatment planning, and specific strategies to implement with individuals with a history of brain injury. Strategies taught were based on current literature and therapeutic methods, adapted …specifically for the clinic’s population of adults experiencing homelessness. RESULTS: Screening for a history of brain injury at the clinic indicated a high prevalence of a history of brain injury that was previously unidentified, indicating need for provider training. Providers reported increased ability to screen for and address the needs of individuals with brain injury within their clinical setting. Providers reported benefit from sessions tailored to address various cognitive functions which incorporated evidence-based practice and familiar therapeutic methods. CONCLUSION: Providers who engage individuals experiencing homelessness benefit from structured training in order to increase ability to screen for and modify interventions for a history of brain injury to better address their clients’ needs. Show more

Keywords: Cognition, mental health, Ohio State University TBI Identification method

DOI: 10.3233/WOR-203080

Citation: Work, vol. 65, no. 2, pp. 285-296, 2020

Authors: Tyminski, Quinn | Gonzalez, Ariana

Article Type: Case Report

Abstract: Life expectancy for persons experiencing homelessness (PEH) is two decades lower than the general population; often, middle-aged adults experience such debilitating health issues due to homelessness that their physical bodies resemble that of a geriatric population. Environmental barriers limiting the ability for PEH to follow medical recommendations and access healthcare often result in decreased health outcomes for this population. The need to participate in survival occupations can reduce time spent in occupations related to health and wellness. This article presents a case study to demonstrate the impact that limited and intermittent access to healthcare can have on quality of life …and wellbeing for PEH. The case study illuminates the significant impact health concerns can cause for a PEH, including eviction from shelters, verbal abuse from staff and peers, and dehumanization. This case study and resulting manuscript are designed to explore the need for health promotion occupations within a population of PEH. Show more

Keywords: Homeless, health management, health maintenance

DOI: 10.3233/WOR-203081

Citation: Work, vol. 65, no. 2, pp. 297-301, 2020

Authors: Kannenberg, Kathleen | Conley, Michelle

Article Type: Case Report

Abstract: BACKGROUND: Approximately 2.2 million people are incarcerated in the United States, a disproportionate number of whom are African American, experience behavioral health conditions and are poor. Various federal and regional policies, compounded by stigma, keep the formerly incarcerated disenfranchised by restricting access to housing, employment and community engagement. OBJECTIVE: This case study highlights how public health crises of one large county led to the piloting of a multidisciplinary team to improve quality of life outcomes for those frequently arrested. METHODS: Occupational therapy was integrated into an interdisciplinary team developed to promote community integration among participants. …RESULTS: Occupational therapy aided the client in overcoming barriers of community engagement while increasing skills for independent living. CONCLUSION: By highlighting evidence-based interventions and multidisciplinary approaches, the case study illustrates the complexity of need among this population and how occupational therapy contributes to housing stability, behavioral health management, occupational engagement and quality of life. Show more

Keywords: Jail, harm reduction, trauma-informed care, motivational interviewing, housing first

DOI: 10.3233/WOR-203082

Citation: Work, vol. 65, no. 2, pp. 303-310, 2020

Authors: Brocht, Chauna | Sheldon, Phill | Synovec, Caitlin

Article Type: Research Article

Abstract: BACKGROUND: Medical respite programs provide a safe place for people experiencing homelessness to recover from an acute illness or injury. Many patients in respite programs have experienced a traumatic brain injury (TBI) that impedes their ability to complete the self-management tasks necessary to recover from an acute medical condition. Patients with brain injuries may also have behavioral problems that are difficult to manage in a medical respite setting. OBJECTIVE: This paper describes the experiences of one medical respite program in screening, assessing, and treating patients experiencing homelessness who have traumatic brain injuries. METHODS: Services by clinical …providers were tailored to better address needs of those with a history of TBI, as well as implementation of environmental modifications. Two retrospective case studies were completed to illustrate the importance of addressing TBIs in respite programs. RESULTS: Modifications to programming can improve patient outcomes and assist in transitioning patients to appropriate community resources. CONCLUSIONS: Identifying and treating patients with TBIs in respite programs can result in long-term positive benefits for patients. Show more

Keywords: Homelessness, rehabilitation, self-management, medical respite program, homeless shelter

DOI: 10.3233/WOR-203083

Citation: Work, vol. 65, no. 2, pp. 311-320, 2020

Authors: Merryman, M. Beth | Synovec, Caitlin

Article Type: Research Article

Abstract: BACKGROUND: Occupational therapists have a long history of addressing community performance and participation challenges faced by individuals with complex, chronic conditions, including those with serious mental illnesses (SMI) and cognitive issues that present with a traumatic brain injury (TBI). Healthcare reform has shifted incentives to support practices that promote successful community life for people with complex medical conditions. Community based care models emphasizing integrated primary care, such as Federally Qualified Health Centers (FQHC) are emerging, and a generalist role for occupational therapy is being defined. Those with complex comorbid conditions such as mental illness, substance abuse and traumatic brain injury …are at risk for negative health outcomes that are further compounded by homelessness. There is a critical need to understand effective treatment options for this population to reduce the negative effects of chronic health conditions. As occupational therapists further define a role serving traditional clients in less traditional settings, such as the FQHC, it is helpful to explore the perceptions of the utility of OT services on the part of provider referrers. OBJECTIVE: This study explored provider referrer perceptions of a new occupational therapy service for homeless adults in an FQHC to assist effective allocation of scarce resources. METHODS: Twelve provider referrers at an FQHC were interviewed regarding their perception of the role and utility of occupational therapy in this setting. Interviews were then coded for themes. RESULTS: Providers identified the unique value of occupational therapy, emphasizing critical information gleaned from the performance-based assessment of functional cognition, and the positive impact on team interactions and subsequent care decisions. CONCLUSION: Occupational therapy provides a distinct perspective on client performance in FQHC settings indicating benefit for inclusion of services. Show more

Keywords: Federally qualified health centers, primary care, integrated care, team-based care, complex comorbidity

DOI: 10.3233/WOR-203084

Citation: Work, vol. 65, no. 2, pp. 321-330, 2020

Authors: Bahr, Elisabeth

Article Type: Research Article

Keywords: Occupational justice, occupational therapy, homelessness, occupational therapy education

DOI: 10.3233/WOR-203075

Citation: Work, vol. 65, no. 2, pp. 331-332, 2020

Authors: Almeida, Ana Margarida Pisco | Beja, Joana | Pedro, Luís | Rodrigues, Fernanda | Clemente, Mariana | Vieira, Rui | Neves, Rui

Article Type: Research Article

Abstract: BACKGROUND: People with visual impairment or blindness face a wide range of daily barriers, both at school and at work. OBJECTIVE: This article describes the development process of an online resource, addressing Occupational Safety and Health (OSH), accessible for students with visual impairment or blindness. METHODS: This study was framed in a Design-Based Research methodology involving the analysis, design, development and implementation of a digital resource. In the analysis stage, a first list of accessibility challenges was created allowing the design of strategies and specific technical solutions to approach them. RESULTS: The development process …has shown that online digital resources can be accessible for users with visual impairment or blindness and even the most visual contents and activities (based on images and videos) can be easily adjusted. CONCLUSIONS: Online accessible resources should be based on the World Wide Web Consortium (W3C) guidelines, allowing the proper description of all contents by screen readers, using audio description, accessible features and providing keyboard navigation. Further research must be conducted to deepen knowledge on the role of educational digital resources for students with visual impairment or blindness, namely regarding OSH barriers that workers with visual impairment or blindness face at the workplace (as visual safety signs and pictogram labels). Show more

Keywords: Accessibility, Occupational Safety and Health, blind, digital media

DOI: 10.3233/WOR-203085

Citation: Work, vol. 65, no. 2, pp. 333-342, 2020

Authors: Rosenfield, Mark | Li, Rui Ting | Kirsch, Nancy T.

Article Type: Research Article

Abstract: BACKGROUND: Many ophthalmic lens manufacturers are currently marketing blue-blocking filters, which they claim will reduce symptoms of Digital Eye Strain (DES). However, there is limited evidence to support the proposal that DES results from the blue light emitted by electronic screens. OBJECTIVE: This investigation compared the effect of blue-blocking filters on DES symptoms with a no-filter lens, using a double-blind methodology. METHODS: Twenty-four subjects were required to perform a 20-minute reading task from a tablet computer. They wore either lenses containing a blue-blocking filter (TheraBlue 1.67 or TheraBlue polycarbonate) or a CR-39 control lens which did …not include a filter. Immediately following each session, subjects completed a questionnaire to quantify symptoms of DES. RESULTS: While a significant increase in symptoms was observed immediately following the near vision task (p  = 0.00001), no significant difference in symptoms was found between the 3 lens conditions (p  = 0.74). CONCLUSIONS: There is little evidence at this time to support the use of blue-blocking filters as a clinical treatment for DES. Management of other ocular factors, as well as the creation of an optimal environment for screen viewing, are more likely to provide greater success in minimizing symptoms. Show more

Keywords: Blue-blocking filter, blue light, computer vision syndrome, digital eye strain, visual symptoms

DOI: 10.3233/WOR-203086

Citation: Work, vol. 65, no. 2, pp. 343-348, 2020

Authors: Hejduk, Irena | Jan Olak, Andrzej | Karwowski, Waldemar | Tomczyk, Przemyslaw | Fazlagić, Jan | Gac, Paweł | Hejduk, Hubert | Sobolewska, Sylvia | Alrehaili, Omar A. | Çakit, Erman

Article Type: Research Article

Abstract: BACKGROUND: Knowledge management is a central resource in achieving the goals of occupational safety efforts. OBJECTIVE: The main objective of this study was to investigate the relationships between the implicit (tacit) and explicit (formal) safety knowledge of employees and their effects on employee propensity to follow safe practices at work. METHODS: A survey with seven safety constructs: 1) tacit safety knowledge, 2) explicit safety knowledge, 3) attitudes toward safety: psychological aspects, 4) attitudes toward safety: emotional aspects, 5) safety culture: behavioral aspects, 6) safety culture: psychological aspects, and 7) propensity to follow safety regulations and safe …work practices (safety at work), was designed and used for data collection. A total of 468 production workers from three manufacturing companies located in southeastern Poland provided valid responses to the self-administered survey. Structural equation modeling was used to analyze the collected data. RESULTS: The results support the hypothesized relationships among tacit and explicit knowledge of safety requirements, procedures, and practices, and the propensity of employees to follow work practices at work through the mediating variables of safety culture (with behavioral and psychological factors) and attitudes toward safety (with psychological, emotional, and behavioral factors). CONCLUSIONS: While both tacit and explicit safety knowledge affect safe practices, tacit knowledge has an important influence on the use of explicit safety knowledge at work. Show more

Keywords: Safety culture, tacit knowledge, explicit knowledge, work practices, structural equation modeling

DOI: 10.3233/WOR-203087

Citation: Work, vol. 65, no. 2, pp. 349-359, 2020

Authors: Daffin, Lee | Stuelcken, Max C. | Armitage, Joshua | Sayers, Mark G.L.

Article Type: Research Article

Abstract: BACKGROUND: Altering the horizontal position of the weight in a backpack will influence the magnitude of the external torque it creates but the effect on posture is unclear. OBJECTIVE: To use photogrammetry to determine if changes in the horizontal position of a fixed backpack weight affect external measures of craniovertebral posture in 150 asymptomatic young adults. METHODS: A backpack was attached to a steel frame with a bar protruding posteriorly. A fixed load (5% body mass) was placed at three distances along the bar –0 m, 0.20 m, and 0.40 m. Sagittal and frontal plane photogrammetry was used to …measure the craniovertebral angle (CVA), upper cervical gaze angle (UCGA) and lateral head tilt angle (LHTA). A comparison was made across unloaded (no backpack) and loaded conditions. RESULTS: There was a significant decrease in the CVA between unloaded and loaded conditions. Changes in the UCGA were small and, while significant, may not have practical importance. There were no differences in the LHTA between the conditions. CONCLUSIONS: Changes in the horizontal position of a fixed load affect external measures of craniovertebral posture so consideration needs to be given to not only the weight of a backpack but how the weight is positioned within the backpack. Show more

Keywords: Photogrammetry, cervical alignment, external measures

DOI: 10.3233/WOR-203088

Citation: Work, vol. 65, no. 2, pp. 361-368, 2020

Authors: d’Ettorre, Gabriele | Pellicani, Vincenza | Vullo, Annamaria | Ceccarelli, Giancarlo | La Torre, Giuseppe

Article Type: Research Article

Abstract: BACKGROUND: Rotational shiftwork (RS) has been linked to increased risk for safety and health of shift workers, globally. A growing literature has revealed a trend toward increased accident and injury rates in shift workers than non-shift workers. AIMS: The present research was aimed: 1) to develop a methodological path for a preliminary objective assessment of occupational risk by RS in a metal industry 2) to detect the consequent effective interventions for moderating the RS risk. METHODS: A modified version of the Rotational Shiftwork Questionnaire was designed by a panel of experts, through a Delphi study; the …questionnaire was used for a pilot study to assess the RS risk in a metal industry. RESULTS: The questionnaire was entitled Rotating Shiftwork Questionnaire-Industry (RSQ-I) and was made up of two sections: 1) Sentinel Events; 2) Risk Factors. The assessment of RS risk showed a medium level of risk in the studied metal industry. Organizational level interventions were detected for moderating the impact of RS-risk on workers’ safety and health. CONCLUSION: RSQ-I showed a valid and reliable tool to analyze RS risk in a 24-hours metal industry. The pilot study demonstrated the effectiveness and feasibility of the introduced RSQ-I to approach the risk, through the analysis of both sentinel events and shift schedules. Show more

Keywords: Shift schedules, circadian rhythm, questionnaire, occupational health, risk assessment

DOI: 10.3233/WOR-203089

Citation: Work, vol. 65, no. 2, pp. 369-375, 2020

Authors: Espanhol-Soares, Melina | Romano, Marina Paiva | Silva, Flávio Soares | Apolinário Silva, Milady Renata | Gimenes, Rossano

Article Type: Case Report

Abstract: BACKGROUND: The aim of this study was to characterize solid particulate aerosol derived from a cutlery microenterprise and to investigate substances associated with activities performed within the work environment. OBJECTIVE: Suspended particulate matter (SPM) was collected at different locations in the cutlery workshop and near machines used by workers, using passive sampling devices fitted with polytetrafluoroethylene filters, onto which total particulate material was deposited. The substances present in the SPM were analyzed using gas chromatography-mass spectrometry (GC-MS). RESULTS: Identification of the substances was performed using the National Institute of Standards (NIST) library and automated mass spectral …deconvolution and identification system. (AMDIS) software, considering at least 70% probability. The concentration of total dust, obtained using a gravimetric method, was approximately 1 mg.m–3 . CONCLUSION: The toxic substances found in the SPM included halogenated hydrocarbons (containing chlorine, fluorine, and iodine) and aromatic hydrocarbons. The toxic substances included naphthalene, which is classified as carcinogenic. Show more

Keywords: Solid particulate matter, occupational risk, emerging pollutants, solid aerosols

DOI: 10.3233/WOR-203090

Citation: Work, vol. 65, no. 2, pp. 377-390, 2020

Authors: Biernat, Elżbieta | Krzepota, Justyna | Sadowska, Dorota

Article Type: Research Article

Abstract: BACKGROUND: Cycling to work has been promoted all over the world. Contemporary employers invest in human capital (create a friendly work environment, care about the quality of life and health of employees). OBJECTIVES: The aim of this study was to evaluate the popularity of cycling to work and the motivations and barriers to this activity. METHODS: The study used data obtained from the survey Using cycling in everyday transportation conducted at the request of the Ministry of Sport and Tourism. The data were collected by means of computer-assisted personal interviewing (CAPI). RESULTS: A …mere 9.9% of Poles commute to work by bike, but they cycle to work on a regular basis (68.6% of respondents do this several times a week for 1 to 6 months). They mostly cycle to improve/maintain health and physical fitness and for reasons concerning environmental protection. According to 49.5% of respondents, the infrastructure at the workplace is insufficient for commuting by bike. A substantial problem is the lack of changing rooms or places to change clothes (44.0%) and no access to showers (22.2%). In the opinions of 66.7%, the promotion of regular commuting to work by bike requires extension of the cycling infrastructure. CONCLUSIONS: The results indicate the necessity of employers’ investment in the infrastructure and cycling facilities. Show more

Keywords: Human capital, health-promoting activities, Poles, bicycle

DOI: 10.3233/WOR-203091

Citation: Work, vol. 65, no. 2, pp. 391-399, 2020

Authors: Takada, Mirian Missae | Rocha, Clayton Henrique | Neves-Lobo, Ivone Ferreira | Moreira, Renata Rodrigues | Samelli, Alessandra Giannella

Article Type: Research Article

Abstract: BACKGROUND: Discrepancies between attenuation obtained in the laboratory and the field are caused by several factors associated with hearing protection devices (HPDs). The effects of some factors can be minimized with proper training provided to HPD users. OBJECTIVE: To evaluate the effectiveness of an educational intervention for improving the correct use of earplugs as HPDs in workers exposed to occupational noise by using the F-MIRE method and by comparing pre- and post-training attenuation values and pass/fail rates. METHODOLOGY: The personal attenuation ratings (PARs) of two types of earplugs were obtained (140 individuals) using E-A-Rfit™ equipment. Each …HPD was evaluated under two scenarios: first after the user only read the packaging instructions, and then after the user read guidelines and participated in a training program. The results obtained were automatically classified by the software as “Approved” or “Failed”. RESULTS: There was a significant post-training increase in the binaural PAR values for both HPDs. The percentages of passes pre- and post-training showed that training users in the proper fit of the HPD was effective; both types had statistically significant differences. CONCLUSION: This study found a statistically significant increase in PARs and the number of workers passing evaluations after HPD fit training, demonstrating the effectiveness of this educational intervention. Show more

Keywords: Hearing, noise-induced hearing loss, educational intervention, occupational health

DOI: 10.3233/WOR-203092

Citation: Work, vol. 65, no. 2, pp. 401-407, 2020

Authors: Sturesson, Marine | Bylund, Sonya Hörnqvist | Edlund, Curt | Falkdal, Annie Hansen | Bernspång, Birgitta

Article Type: Research Article

Abstract: BACKGROUND: General practitioners (GPs) have expressed difficulties in issuing sickness certificates and problems may arise if this work is not performed in an adequate manner. There is scant knowledge about how collaboration with other professions could be organized to enhance this work. OBJECTIVE: Evaluate the feasibility of occupational therapists (OTs) performing supplementary assessments for persons on sick leave. METHODS: Four healthcare centres (HCs) tested a working approach intervention where sick-listed patients were offered a complementary occupational therapy assessment. The OT assessments were intended to provide useful information for GP issued extended sickness certificates. Data on sick …leave, sickness certificates and patient questionnaires were collected at different HCs. Interviews were conducted with GPs and OTs and the Consolidated Framework for Implementation Research was used to analyse the intervention’s implementation. RESULTS: No major differences in the sickness certificate quality was found. Available data on sick leave increased for all HCs during the project. Not all GPs used the OT assessments, which indicates that the implementation of the intervention was insufficient. CONCLUSION: Testing a new working approach in primary healthcare requires an implementation strategy. To improve sickness certification quality, this work needs to be prioritized as an important healthcare task. Show more

Keywords: Sick leave, health plan implementation, feasibility study, general practitioners, occupational therapists

DOI: 10.3233/WOR-203093

Citation: Work, vol. 65, no. 2, pp. 409-420, 2020

Authors: Tariah, Hashem Abu | Nafai, Said | Alajmi, Mutrik | Almutairi, Fahad | Alanazi, Badr

Article Type: Research Article

Abstract: BACKGROUND: Nurses are considered the group of healthcare workers with the highest prevalence of Work-Related Musculoskeletal Disorders (WRMDs). The most common physical demands of nursing that have been found to contribute to WRMDs include lifting, working in awkward postures, stooping, and repetitive actions. Occupational therapists (OT) have a significant role in preventing WRMDs. OBJECTIVE: The purpose of this study was to explore that magnitude of the WRMDs among nurses in the Kingdom of Saudi Arabia (KSA). Exploring the role of OT in increasing awareness and prevention of WRMDs among nurses. METHODS: The study was conducted using …a cross-sectional questionnaire design. Data was collected using the Nordic Musculoskeletal Questionnaire (NMQ). Nurses at King Abdulaziz Medical City, Riyadh, KSA, were the target of this study. RESULTS: Ninety-four nurses participated in this study. Most of them (63.8%) indicated that they experienced discomfort during the last 12 months in their lower back, followed by shoulders (50%), and upper back (48.9%). Twenty-four (25.5%) of the participants who indicated experiencing low back discomfort, also indicated that this discomfort reduced their work activity, and this same number indicated that the discomfort reduced their leisure activity. CONCLUSION: Nurses are at high risk for WRMDs. Occupational therapists have an important role to play in prevention. Measures should be taken by hospital administrators, the rehabilitation departments, as well as the nurses themselves to manage this global problem. Special measures should be implemented to make sure that they work in ergonomically appropriate environment, and implement proper body mechanics to limit their chances of encountering WRMDs. Show more

Keywords: Occupational therapy, prevention, nurses, work-related musculoskeletal disorders

DOI: 10.3233/WOR-203094

Citation: Work, vol. 65, no. 2, pp. 421-428, 2020

Authors: Fuentes-Ramírez, L.D. | Alfaro-Gomez, U. | Espinosa-Uribe, A.G. | Teran-Garza, R. | Quiroga-Garza, A. | Gutiérrez-de la O, J. | Vilchez Cavazos, F. | Guzman-Lopez, S. | Elizondo-Omaña, R.E.

Article Type: Research Article

Abstract: BACKGROUND: The use of smart phones is now part of the daily routine throughout the world. Morphological alterations have been described associated with telephone holding technique, as well as clinically significant alterations related to their use. OBJECTIVE: The objective was to determine the macroscopic morphological changes due to smartphone use in the fifth finger of the hand with which the smartphone is commonly used. METHODS: University students were invited to participate. Photographs of the dorsal region of both hands were taken using a millimeter paper as background. After calibrating the ImageJ software, photographs were analyzed in …pairs obtaining areas of asymmetry. Sociodemographic information and technique of use was collected through a survey. The data were analyzed using SPSS ver. 20. RESULTS: A total of 143 participants were included. The mean age was 20 years. No significant differences were found between the area of asymmetry and the miniferet of both fingers of the subjects compared with age, gender, BMI, daily time of use, years using a smartphone or the type of holding technique. CONCLUSIONS: No asymmetric changes were evident between left and right small fingers in relation to the holding technique of a smartphone in a young adult population. Show more

Keywords: Anatomy, ergonomics, cellphone, morphology, hand

DOI: 10.3233/WOR-203095

Citation: Work, vol. 65, no. 2, pp. 429-433, 2020

Authors: Folgo, Ashley R. | Iennaco, Joanne DeSanto

Article Type: Research Article

Abstract: BACKGROUND: Management of violent acts of patients and their visitors in psychiatric and hospital settings has been studied. However, violence has not yet been addressed in the ambulatory care environment. OBJECTIVE: To identify potential risk factors for patient and visitor violence [PVV] and staff perceptions of the impact of these risk factors in ambulatory care. METHODS: A review of psychiatric inpatient research was conducted examining violence and aggression including risk factors for PVV. Identified risk factors for violence were incorporated into a survey tool and distributed to staff in a community clinic asking for their perception …of the impact of these risk factors on aggression in their work environment. RESULTS: Risk factors for violence and aggression were categorized as static or dynamic or as related to characteristics of staff or the environment of care. All of the risk factors were identified as possible contributors to PVV by the staff while items related to substance abuse and the clinic environment were selected by the staff as “highly likely” to contribute to PVV in their setting. CONCLUSIONS: Continued research is needed in this area to better understand risk factors for PVV and develop appropriate safety interventions and crisis training for ambulatory care settings. Show more

Keywords: Workplace violence, safety, outpatient clinics

DOI: 10.3233/WOR-203096

Citation: Work, vol. 65, no. 2, pp. 435-445, 2020

Authors: Guzik, Agnieszka | Kwolek, Andrzej | Drużbicki, Mariusz | Przysada, Grzegorz

Article Type: Review Article

Abstract: BACKGROUND: The incidence of stroke is growing in various parts of the world and the condition most commonly affects the adult population. OBJECTIVES: The purpose of the study is to provide a narrative review of papers published in the last 11 years in English and in Polish and focusing on demographic characteristics of individuals returning to work after stroke, return to work rates, length of time post stroke to return to work as well as health conditions, or personal and environmental factors associated with return to work after stroke. The study also presents the situation regarding return to …work after stroke in Poland in comparison to other countries. METHODS: The narrative review covers Polish and foreign literature published between 2007 and 2018. The number of records initially identified through English databases search amounted to 4,912. Five records were additionally identified through other sources (Polish databases). Ultimately 26 (21 foreign, 5 Polish) refereed publications were selected to be reviewed in this study, based on their relevance in terms of specific inclusion/exclusion criteria. RESULTS: The appraisal of Polish and English-language literature shows that stroke survivors’ ability to return to work varies; in our country the rate being 43% and outside of Poland reaching the rate of 74.7%. Average time frames for return to work for stroke survivors include from 3 to 6 months, from 12 to 18 months and up to 3 years post stroke. One of the most frequently reported positive factors in the English-language literature is individually tailored vocational rehabilitation. There is a scarcity of studies related to return to work after stroke in Poland. CONCLUSIONS: The findings from studies included in this narrative review may suggest a need to improve the situation in Poland with regard to measures related to return to work after stroke, including vocational rehabilitation which is insufficiently available in Poland. Show more

Keywords: Engagement in work, factors related to return to work, working age

DOI: 10.3233/WOR-203097

Citation: Work, vol. 65, no. 2, pp. 447-462, 2020

Authors: Serranheira, F. | Sousa-Uva, M. | Heranz, F. | Kovacs, F. | Sousa-Uva, A.

Article Type: Research Article

Abstract: BACKGROUND: Occupational physical demands are commonly assumed the cause of work-related Low Back Pain (LBP) and absenteeism. OBJECTIVES: To analyse relationships between LBP at work, physical demands and absenteeism. METHODS: Workers filled out a questionnaire on socio-demographic and work-related factors, general health, LBP (number of episodes in a 12-month period, pain severity and intensity), and occupational hazards related with physical demands. RESULTS: 735 workers completed the questionnaire (male n  = 359). A high proportion of workers n  = 507 (69%), from different occupational backgrounds, reported at least one LBP episode in the previous 12-month period. The …highest ratio of subjects with more than 6 episodes of LBP per year was found among public services employees (31.8%) and the lowest ratio among administrative workers (10.3%). The highest ratio of workers (39%) were classified as sedentary workers, 34% of workers having a low or moderate level of physical demands in their work, and 27% reported high levels of physical demands in their work. There was a 4 % absenteeism rate in a 12-month period, which was significantly higher in the group with physically demanding work. Those subjects with higher physical requirements at work have increased odds of having more than 3 episodes of LBP during the previous year (p  < 0.05) in comparison with subjects with more sedentary jobs and those with low or moderate physical demands. High intensity work, compared to sedentary work, is associated with an increased probability of being absent of work because of LBP in a previous 12-month period (OR = 3.12; CI 1.23-7.89; p  = 0.016). CONCLUSIONS: Our findings suggest there is an association between highly physically demanding jobs, LBP and absenteeism. These results may contribute to the improvement of LBP assessment and prevention programs in Occupational Health Services. Show more

Keywords: Occupational health, occupational disorders, ergonomics

DOI: 10.3233/WOR-203073

Citation: Work, vol. 65, no. 2, pp. 463-469, 2020