Purpose: The overall aim of this thesis is to contribute new knowledge by examining psychosocial factors and return-to-work profiles of occupational low back pain patients in a rehabilitation clinic. Outcome measures for injured workers with subacute low back pain included: change in measures, program utilization, pain profiles and return-to-work. Methods: A total of 147 patients who met the eligibility criteria and consented, participated in a clinic-based, individualized, exercise-based treatment that included patient education and reassurance. A before-and-after design was used, with data collection on admission to and discharge from the program. Results: Pre-to-post analyses revealed that statistically significant improvements had occurred. However, subgroup analyses revealed differences in responses to treatment among the subgroups. Specifically, two sets of cluster analyses were conducted; each yielded two distinct subgroups of patients, one set with different lengths of time in the program, and another showing two pain intensity profiles. Furthermore, return-to-work rates varied between the groups although the overall return-to-work rate appeared high. Conclusion: Significant improvement was achieved following participation in the return-to-work rehabilitation program. However, participants with subacute nonspecific low back pain do not form a homogenous group in terms of their clinical presentation and responses to rehabilitation. Therefore, special attention might be warranted for subgroups within the sample, whom are at an increased risk for prolonged disability. / Thesis (Ph.D, Kinesiology & Health Studies) -- Queen's University, 2007-09-28 15:40:39.13

Traumatic Brain Injury (TBI) is a significant public health concern that affects an estimated 5.3 million Americans. Approximately, 1 out of every 60 individuals experience a disability related to TBI, thus highlighting the significant burden on the affected population (ASBMB, 2021). A study conducted by Sharma et. al, stated that only 40.8% of individuals were able to return to employment after two years of experiencing BI, while a significant proportion of 20% remained unable to resume work due to the secondary deficits of their BI (2022). Evidence indicates that return-to-work (RTW) rates among individuals diagnosed with BI are significantly lower due to physical and cognitive deficits. The presence of unemployment, especially among the BI population can result reduced opportunities for community engagement, a loss of sense of purpose or identity, and a notable decline in overall quality of life (QoL). Occupational therapy (OT) is critical in the development of employability skills necessary for successful community reintegration including RTW. Despite this connection, there is no training module for professionals to refer to when delivering prevocational services to individuals with BI. In the attempt to bridge this gap, the Comprehensive Intervention for Prevocational Programming (CIPP) was developed and implemented. The CIPP represents an OT centered approach designed to facilitate the RTW process following a brain injury (BI). The primary goal of CIPP is to provide professionals with education on the prevocational process, enabling successful RTW. This intervention is structured around four modules, each serving distinct purposes: introduction to prevocational services, examination of BI's impact on RTW, outlining covered services, and defining the Occupational Therapy Practitioner's (OTP) role within the prevocational sector. Results of the study provided clinical evidence supporting the effectiveness of the CIPP as an impactful tool in educating professionals on the delivery of pre-employment services and further defining the role of the OTP in this domain. / Temple University. College of Public Health / Health and Rehabilitation Sciences

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Physiotherapy Johannesburg, 2012 / Introduction: Stroke continues to be a major public health problem for both the developed and developing world despite the various advances in health care. The economic burden of stroke is ever increasing and in light of this, return to work post-stroke is becoming an important area of research for therapists. Thus the main aims of the study were to establish the rate of return to work of patients following stroke and to establish the patients’ perceived factors which influence their return to work after stroke. Method This was a quantitative cross sectional study. A sample of convenience of ninety seven participants were selected from a list of patients obtained from various rehabilitation units and government clinics within the Gauteng province. A self-designed questionnaire was used. A pilot study was conducted to determine the questionnaire’s reliability and validity, and the validity, inter-rater and intra-rater reliability were all found to be satisfactory. The participants were contacted and interviewed at their homes or a location suitable for them using a self-designed questionnaire. The percentage of patients that returned to work was determined and reasons for returning or not returning to work were summarised using frequencies and percentages. A univariate and then multivariate analysis was performed to establish perceived factors which had an influence on return to work Results The study sample had more males than females with an overall mean age of 51years. They were mostly black and between 18 months and 24 months post-stroke. The most common co-morbidities were fatigue and hypertension. There was a 34% return to work rate, with 3% stopping work after a period of time, leaving 31% of the sample working at the time of interview. The most common reasons for returning to work were financial (77%), enjoyment of work (77%) and personal development (73%). For those who did not return to v work the two most common reasons were upper limb dysfunction (61%) and walking difficulties (53%). The main factors that decreased likelihood of return to work included depression and not paying life insurance or monthly car repayments. Conclusion The return to work rate following stroke in this study group is in line with other countries around the world, although it is still relatively low with less than a third of patients with stroke returning to work. Enjoyment of work was shown to be as important a motivating factor for return to work as finances, and physical fallout was the most demotivating factor. Depression was the most likely factor to decrease return to work.

No description available.

Norway has a high prevalence of sick leave compared to other Nordic countries and has been criticized for offering generous sick leave benefits. This qualitative study aims to explore experiences of graded sick leave and return to work in Norway. Six employees from the private sector were interviewed regarding their experiences of the Norwegian model for earlier follow-up of employees on sick leave. The collected data was analyzed using qualitative content analysis. The results indicated several important aspects of the return to work process which were perceived as both obstacles and opportunities. The possibility of having time to recover as well as finding a balance of a manageable work load with stimulating assignments were seen as essential and communication was crucial to attain the latter.

<p>The background to the thesis is the high rate for sickness absence in Sweden since the end of the 1990s. In an international perspective, the Swedish sickness absence appears exceptionally high. This can appear paradoxical bearing in mind the high standard of living and the high average length of life in Sweden, and there is much to indicate that complex causal correlations are involved.</p><p>The overall aim of the thesis is to study and analyse the return to work or transition to disability pension, for persons on long-term sick leave from their own perspective. The focus of the thesis is the individual in a social context.</p><p>The theoretical frame of reference is within medical sociology and is about sickness concepts and models and on medicalisation. The concept of work capacity is also taken up based on the concepts of disability and impairment.</p><p>The empirical material consists of four studies. Two of these are qualitative interview studies with women. One of them (I) is about Greek women who have been granted Swedish disability pension. The aim of this study is to find explanations why such a large number of Greek women have become disability pensioners in Sweden. The analysis indicated some important factors: the doctors, the family and the social insurance system. The women had unclear psychosomatic complaints, which had been medicalised. The other qualitative study (IV) concerned women who after sick leave and rehabilitation succeeded in returning to work. It was seen to be strong and stubborn women who had to struggle to get back to working life. They had also been well taken care of in rehabilitation.</p><p>The other two studies (II and III) are quantitative, prospective cohort studies with persons on sick leave with unspecified back and neck complaints. One main aim of one study (III) was to investigate the importance of motivation for rehabilitation and return to work. Two specially designed forms were used. It was seen, among other things that the forecasts of the person on sick leave on return to work coincided quite well with a follow-up two years later. One important result was that those who had undergone rehabilitation measures had returned to work to a much lesser extent than those who had not.</p><p>Overall, the results showed the importance of listening to the individual and taking their own assessments of obstacles and possibilities in the rehabilitation process into consideration. The results in study III indicated that rehabilitation had not been sufficiently effective and in many cases did not lead to a return to work.</p>

The background to the thesis is the high rate for sickness absence in Sweden since the end of the 1990s. In an international perspective, the Swedish sickness absence appears exceptionally high. This can appear paradoxical bearing in mind the high standard of living and the high average length of life in Sweden, and there is much to indicate that complex causal correlations are involved. The overall aim of the thesis is to study and analyse the return to work or transition to disability pension, for persons on long-term sick leave from their own perspective. The focus of the thesis is the individual in a social context. The theoretical frame of reference is within medical sociology and is about sickness concepts and models and on medicalisation. The concept of work capacity is also taken up based on the concepts of disability and impairment. The empirical material consists of four studies. Two of these are qualitative interview studies with women. One of them (I) is about Greek women who have been granted Swedish disability pension. The aim of this study is to find explanations why such a large number of Greek women have become disability pensioners in Sweden. The analysis indicated some important factors: the doctors, the family and the social insurance system. The women had unclear psychosomatic complaints, which had been medicalised. The other qualitative study (IV) concerned women who after sick leave and rehabilitation succeeded in returning to work. It was seen to be strong and stubborn women who had to struggle to get back to working life. They had also been well taken care of in rehabilitation. The other two studies (II and III) are quantitative, prospective cohort studies with persons on sick leave with unspecified back and neck complaints. One main aim of one study (III) was to investigate the importance of motivation for rehabilitation and return to work. Two specially designed forms were used. It was seen, among other things that the forecasts of the person on sick leave on return to work coincided quite well with a follow-up two years later. One important result was that those who had undergone rehabilitation measures had returned to work to a much lesser extent than those who had not. Overall, the results showed the importance of listening to the individual and taking their own assessments of obstacles and possibilities in the rehabilitation process into consideration. The results in study III indicated that rehabilitation had not been sufficiently effective and in many cases did not lead to a return to work.

Mental health problems have incapacitating effects on an individual’s capacity to hold and maintain employment. Over half a million Canadians are absent from work due to mental health problems every day, which costs Canadian companies an estimated 14% of their net annual profit. Individuals who miss work for mental health reasons often experience longer periods of absence, and return to work at a much lower rate than individuals absent for other reasons (e.g., physical injury). Regrettably, empirically based return to work interventions focused on mental health problems are lacking, likely the product of a lack of consensus surrounding salient predictors of return to work. The current study sought to add to current literature aimed at identifying factors that influence the likelihood of successful re-entry into the workforce. A review of patient files from a private psychological practice yielded the sample. Clients were selected based on their satisfaction of one central criterion: having experienced a workplace absence and suffered from a mood or anxiety disorder as classified by the DSM-IV-TR. Recruitment letters and consent forms were mailed to 74 eligible participants, for a response rate of 68% (n=50). The sample was predominantly female (n=38 or 76%). Of the 50 participants, 27 successfully reintegrated to the workforce (RTW=54%), following a mean absence of 13 months (SD=7.37). Emerging from the results are higher risk categories (e.g., physically injured workers, low educational requirements, disability providers) of reduced likelihood of successful return to work. The role of symptom severity and availability of social support is also discussed along with best practice implications for stakeholder/practitioners.

No description available.

Forskning kring stressrelaterad ohälsa är vanligt förekommande idag, speciellt kring arbetsrelaterad stress och utmattning. Dock är forskning om återgång i arbete efter utmattning bland läkare tämligen begränsad. Syftet med studien är att undersöka hur läkare som har varit sjukskrivna i utmattning upplever återgången i arbetet, samt vilka faktorer som underlättat eller försvårat återgången. 12 läkare intervjuades med hjälp av en semistrukturerad intervjuguide. Den tematiska analysen av faktorer som underlättade återgången identifierade fem teman, vilka var rehabiliteringsplan från organisationen, socialt stöd från chefen, byte av arbetsplats, tydliga gränser och socialt stöd från anhöriga och kollegor. Den tematiska analysen av faktorer som försvårade återgången identifierade 4 teman, vilka var ansvarsförskjutning av rehabiliteringsplan, frånvarande chefskap, skam och skuld, och kollegialt utanförskap. Viktigast för en lyckad återgång var en anpassad rehabiliteringsplan med en närvarande närmaste chef.