Background Musculoskeletal disorders (MSDs) are one of the most important causes of temporary and permanent disability, causing acute or persistent pain, resulting in reduced and/or lost ability to work. Return to work (RTW) is multidimensional problem including many different factors and aspects. Few recent studies have analyzed factors predicting RTW after multimodal rehabilitation (MMR). Identification of predictors for RTW may help to improve the planning and optimization of the RTW strategy. The REHSAM II project is a randomized controlled trial with the aim to evaluate if MMR together with a web Behavior Change Program for Activity could increase work ability among persons with persistent MSDs as compared to MMR. Therefore the aim of this study was to identify factors explaining RTW 12 month after baseline in the REHSAM II project. Methods The present study is a secondary assessment of the data from the randomized controlled trial REHSAM II. A total of 97 participants with persistent musculoskeletal pain were randomly allocated to MMR + web-based education or only MMR group. The subjects were followed from baseline to 12 months. Information on potential predictors was obtained from self-administered questionnaires. Data were analyzed with univariate and multiple logistic regression models. Results In the final multiple regression model RTW was predicted by the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ score) (p=0.003, OR=0.961) and EuroQol (EQ-5D index) (p=0.017, OR=7.283). The univariate regression analyses showed that pain and disability level, the capacity to perform a task in relation to pain and other symptoms, hospital and psychiatric care, medication for insomnia, catastrophizing, self-assessed work ability compared with the lifetime best, satisfaction with life, ability for coping and controlling work situation, ability for coping with life outside work and sense of responsibility for managing health condition were significantly associated with RTW. Conclusion In conclusion, psychosocial pain-related variable and health-related quality of life predicted RTW in the final model. The result confirms the fact that RTW is a multidimensional problem involving a complex interaction of many factors.

Magister Scientiae (Occupational Therapy) - MSc(OT) / Return to work is a recognised goal of rehabilitation by the occupational therapy discipline that is addressed through vocational rehabilitation as a key feature of work practice. Programmes that fall under the umbrella of vocational rehabilitation include work preparation and training, work hardening and supported employment. In the case of mental health care users (MHCU), meaningful employment contributes to their sense of identity and the prevention of relapse. Vocational rehabilitation is thus important in preparing MHCU for self-employment or employment in the community after they are discharged from the hospital. There is however a dearth of literature pertaining to how vocational rehabilitation programmes particularly in a rural setting, is experienced by MHCU in South Africa. Therefore, the aim of this study was to explore the experiences and perceptions of MHCU regarding the usefulness of the vocational rehabilitation programme at a rural hospital in enhancing their worker roles. A qualitative research approach and exploratory descriptive research design was utilised. Purposive sampling was used to select participants for the study. Semi-structured interviews were conducted with ten MHCU participants as well as two focus groups. Semi-structured interviews were furthermore conducted with two key informants. All interviews and the focus group discussion were audio-recorded, transcribed verbatim and analysed through thematic data analysis. Strategies implemented to ensure trustworthiness included member checking and peer review. Ethics clearance was obtained from the UWC Research Committee and permission to conduct the study at the hospital was requested from the Mpumalanga Provincial Health Ethics Committee and hospital management. Three themes originated from the findings of this study. Theme one describes the barriers experienced by people with mental illness while returning to work. Theme two describes the programme factors that influence return to work in respect of work habits, work skills, and community re-integration. Theme three captures the value of participating in the work programme as experienced by the participants. The findings of the study is related to the Model of The Ecology of Human Performance (EHP) to show how the vocational rehabilitation programme effected the MHCU’s return to work. The findings show that the context as well as the person’s skills and abilities are very important factors in reintegrating the user back to work. The study illuminated recommendations for the further development of the vocational rehabilitation programme.

Syftet med litteraturstudien var att undersöka när arbetsterapeuten blir involverad i den arbetslivsinriktade rehabiliteringen för individer som är sjukskrivna till följd av utmattningssyndrom och stressrelaterad psykisk ohälsa, hur arbetsterapi tillämpassamt vilken effekt arbetsterapeutiska insatser har på klientens återgång i arbete. Insamlingen av data gjordes genom sökningar databaserna CINAHL, PsycINFO, Cochrane, PubMed, SveMed+ samt Amed via Luleå tekniska universitetsbibliotek under perioden februari till mars 2019. Totalt valdes tio artiklar ut för att ingå i studien. Resultatet visar att ingen av studierna med tydlighet när arbetsterapeuten blev involverad i klientens arbetslivsinriktade rehabilitering. Resultatet gällande hur arbetsterapi tillämpasför klientgruppen visade generellt att arbetsterapeuten själv eller i multidisciplinära team utför interventioner riktade mot aktivitetsbalans och att det sker främst i kontexten svensk primärvård och rehabiliteringskliniker. Effekterna av de arbetsterapeutiska insatserna på klientens återgång i arbete presenteras endast i tre studier och sammantaget visade resultaten på små effekter, samtatt evidensen som presenterades var låg eller måttlig. Författarnas slutsatser är att det saknas studier av högre evidensstyrka på området samt att den evidens som presenteras i studierna är bristfällig. Författarna konstaterar att det behövs mer forskning på ämnet och klientgruppen samt att de olika professionernas del i insatserna behöver tydliggöras för att det skall vara möjligt att urskilja betydelsen av arbetsterapi för återgång i arbete. / The aim of the literature study was to investigate when the occupational therapist becomes involved in the work rehabilitation of individuals who are sick-listed as a result of exhaustion disorder and stress-related mental health, how occupational therapy is applied and what effect occupational therapy interventions have on the client's return to work. The collection of data was done by searching the databases CINAHL, PsycINFO, Cochrane, PubMed, SveMed + and Amed via Luleå technical university library during the period February to March 2019. A total of ten articles were selected for inclusion in the study. The result show thatnone of the studies describes with clarity when the occupational therapist becomes involved in the work rehabilitation. The results regarding how occupational therapy is being used for the client group generally shows that the occupational therapist alone or in multidisciplinary teams perform interventions directed toward activity balance, primarily in the context of swedish primary care and rehabilitation clinics. The effects of the interventions on the client's return towork were presented in only three of the studies and the overall results show small effects, and the evidence presented is of low or moderate quality. The author ́s states that more research is needed on the subject and the client group, and that in future studies each professions part of the efforts need to be elucidated so that it is possible to distinguish the importance of occupational therapy for return to work.

>Magister Scientiae - MSc / Globally, high unemployment rates exist amongst individuals with schizophrenia. Evidence suggests that these individuals have a desire to return to work (RTW), however, they experience difficulty in finding as well as sustaining employment. Work plays a pivotal role in the functioning of individuals with schizophrenia and has a substantial positive influence on their quality of life (QOL). Several studies recommend supported employment as a practice aimed at improving rates of competitive employment for individuals with schizophrenia. The current study aimed to explore the experiences and perceptions of individuals, with a primary diagnosis of schizophrenia, about the use of the Model of Occupational Self-Efficacy (MOOSE) as a supported employment strategy in enhancing the work skills and facilitating RTW in the open labour market. A qualitative research design was utilised to explore these experiences and perceptions from nine participants. Additionally, one occupational therapist and one occupational therapy technician were selected and participated as key informants of the study. Participants were selected through the use of purposive sampling. Written informed consent was received from the participants, and their confidentiality was upheld throughout the study. Semi-structured interviews were used to collect data, and were audiotaped and transcribed verbatim. Transcriptions were anal

Mothers who leave the workforce to raise children may face personal and professional difficulties when returning. There was a lack of qualitative research on what these women experience in their return to work. The purpose of this study was to discover and describe how a mother in a professional or managerial position experiences a return to the workforce after a hiatus of 2 or more years to raise children. The philosophy of Husserl and the methodology of Moustakas guided this transcendental phenomenological study. Through purposive snowball sampling, 12 women participated in semistructured interviews. Data analysis followed the Stevick-Colaizzi-Keen method leading to a synthesis of participants' lived experiences. Key findings of the essence of the experience were identified in 6 major themes: deciding to return, changing career path, changes in the workplace, feelings upon return, changes at home, and reflections. Social change implications include heightening awareness among women and their families about the process of returning to work after leaving a professional job to care for children. Policymakers may benefit from the information to support mothers' efforts to return to work after a child-rearing hiatus through programs designed to support the reentry of mothers to the professional workplace. Life and career coaches may use findings to prepare women for the reentry process.

This thesis explores the occupational health and safety risks facing labour hire employees (also known as temporary agency workers) in the Australian state of Victoria. Three questions are considered. First do labour hire employees face greater risk of injury and disease than direct hire employees? Second, if so, which characteristics of labour hire employment contribute to a higher rate of injury? Third, what characteristics of labour hire employment reduce the likelihood of injured employees returning to work and being rehabilitated? The first question is answered by an aggregate analysis of data drawn from all workers' compensation claim files in Victoria between 1994/5 and 2000/1 contrasting the frequency of injury for both temporary agency employees and direct hire employees. Second a unique sub sample of individual investigated claim files was then examined to test employment factors that could account for the higher frequency of injury amongst agency workers. A third data source involved a survey and focus groups of temporary agency workers. This provided supplementary data on the work experiences of labour hire employees. A number of conclusions are drawn. Labour hire employees are more likely to be injured at work than their direct hire counterparts. Factors explaining this include economic pressures, disorganisation at the host workplace, and regulatory failure for agency employees. Several of these factors are uniquely related to the triangular nature of labour hire arrangements. Once injured at work, labour hire employees are especially disadvantaged relative to direct hire employees through the reluctance of many labour hire employers to offer further employment. This reduces the capacity of labour hire workers to return to meaningful employment. Regulatory failure stemming from both employment and occupational health and safety legislation underpins the greater likelihood of agency workers being injured at work and then dispensed with by employers. Until the uniqueness of their triangular relationship with employers and hosts is recognised through appropriate regulatory intervention, their greater occupational health and safety risks will not be overcome.

This critical hermeneutic study explored what it is like to re-enter the workforce following long-term forensic hospitalisation. An in-depth analysis of the phenomenon was completed, with the aim of evoking insights and developing understandings about the lived return-to-work experience. As this research was situated within the critical paradigm, the process of seeking, securing and sustaining employment was viewed in terms of power relationships, and through the multiple positionings of psychiatric disability, employment status and social capital.An unstructured interview process was used to explore the return-to-work experiences of eight purposefully selected informants with a history of mental illness and prior illness-related offending. They were living in the community and had returned to part or full-time employment, which they had sustained for at least six months. The gathered data was interpreted using hermeneutic analysis. This process revealed a number of themes, which were clustered into related groups, under eleven essential overarching themes. Freire's (1972) critical social theory was used to add critical depth to the findings.The findings reveal that returning to work exposes people who are affected by mental illness to an array of challenges and personal opportunities. People who have a forensic psychiatric history can encounter complex employment barriers related to stigma and misunderstanding. Therefore, the selected critical hermeneutic design provided a congruent framework with which to view the informants' quest to seek, secure and sustain employment. Despite significant obstacles, securing employment provides opportunities for individuals to test their skills while engaged in meaningful work activity. The acquisition of work skills can result in individuals' experiencing a strong sense of self-satisfaction. The experience of being bolstered by personal accomplishment often co-exists with, but is not necessarily negated by, difficulties that arise on-the-job.As there is scant reference to forensic rehabilitation within the mental health vocational literature, this study may be a timely contribution. It may also be used to add depth to the knowledge base within the field of mental health rehabilitation, in particular the specialised areas of forensic rehabilitation and vocational practise. Therefore, it may be a positive precursor to further discussion and analysis regarding work and education outcomes from the unique forensic psychiatric perspective.

The focus of this inquiry is “New Zealand small business employers’ perspectives of the important factors in return-to-work (RTW) of an employee following a musculoskeletal injury or an illness”. Whilst worldwide there is an increasing amount of attention focused on the RTW process in large organisations, there continues to be little understanding of this phenomenon in small businesses. I chose to use a social constructivist theoretical framework drawing on grounded theory methodology to construct some understanding of the employers’ perspectives of the RTW process. Eight small business employers from Auckland and Christchurch participated in this research. Data were gathered using semi-structured interviews. Constant comparative analysis, theoretical sampling and thematic analysis were used to construct two themes from the data. The findings showed that small business employers prefer informal organisational approaches, rely on close working relationships with their staff, are generally wary of bureaucracy and often must run their businesses with limited staff and financial resources. Having an employee off work for a prolonged period of time creates a sizable gap in the staff resources that keep the business running. The employer has responsibility to fill this gap while maintaining a productive business. In the absence of formal injury management practices an ad hoc approach was taken to the RTW process. A number of the employers felt undervalued by key stakeholders, such as doctors, treatment providers, Accident Compensation Corporation and in some cases RTW co-ordinators. Health and safety was a risk all employers appeared to take seriously whereas injury management information and support seemed less of a focus. This research suggests there may be little focus on injury management in small businesses by employers and, that employers perceive greater government emphasis on injury prevention. The extent and associated costs of work disability in small businesses is as yet unknown, but it is likely to be significant. How to support and encourage the uptake of injury management in small businesses in the long term warrants further investigation. Understanding that employers may well lack injury management expertise, experience and resources requires stakeholders to make specific effort with the employer, at the workplace, to facilitate the RTW process.

<p>Den nya rehabiliteringskedjan med sina fasta tidsgränser för långtidssjukskrivna har fått stor uppmärksamhet i svensk media under senare tid. De nya reglerna fokuserar framförallt på tidiga insatser för långtidssjukskrivna med målet återgång i arbete. Intervjuerna i föreliggande studie utfördes med sju försäkrings-kassahandläggare på olika försäkringskontor. Syftet var att undersöka vilka erfarenheter och upplevelser handläggarna på Försäkringskassan har av den nya rehabiliteringskedjan och arbetslivsinriktad rehabilitering. Resultatet visade att det är en mängd olika faktorer som påverkar handläggarnas arbete. Som viktiga faktorer uppgav handläggarna ett ändrat regelverk med fasta tidsgränser, samarbetet mellan olika aktörer för den försäkrades återgång i arbete, handläggarnas och andra aktörers engagemang samt den försäkrades egna resurser. Vidare forskning inom området arbetslivs-inriktad rehabilitering behövs, om den nya rehabiliteringskedjans effekter på tidigare återgång till arbetslivet verkligen innebär ökat stöd till de långtidssjukskrivna. Även andra rehabiliterings-aktörers erfarenheter av de nya sjukskrivningsreglerna behöver utforskas.</p>

<p>Work has a great influence on most of individuals in society. It influences both identity as well as the structure of the day. Unemployed people are often affected in a negative way through economic and psychological problems. In order to help people with reduced work capacity back to the labour market and decrease unemployment, the Labour Market Board works with vocational rehabilitation. The aim of this study is to investigate experiences of vocational rehabilitation within the Labour Market Board among unemployed people. A qualitative method was used by which interviews were made with 11 unemployed persons who participated in an investigation as a part of vocational rehabilitation within the Labour Market Board. The result shows both positive and negative experiences of the investigation period. The identified experiences were sorted into code groups: Support, Insight, Confidence in the investigation and result, Belief in the future, Motivation, and Participation. Both the actions of the personnel and the presence of the group members influenced the experiences. The support given by the personnel and how it is experienced is of great importance for the future of the unemployed. When the investigation was pursued during a short period of time, there was a lack of confidence in the investigation and result. A suggestions for future studies is to design a questionnaire that can be used in a larger study including a large number of individuals who are participating in vocational rehabilitation within the Labour Market Board.</p>