Work - Volume 44, issue 4

Article Type: Other

DOI: 10.3233/WOR-131515

Citation: Work, vol. 44, no. 4, pp. 381-381, 2013

Authors: Cho, Elizabeth | Chan, Kee

Article Type: Research Article

Abstract: OBJECTIVE: Individuals living with HIV face challenging employment decisions that have personal, financial, and health impacts. The decision to stay or to leave the work force is much more complicated for an individual with HIV because the financial choices related to potential health benefits are not clearly understood. To assist in the decision-making process for an individual with HIV, we propose to develop a decision model that compares the potential costs and benefits of staying in …or leaving the work force. PARTICIPANTS: A hypothetical cohort of HIV-infected individuals was simulated in our decision model. Characteristics of these individuals over a one-year period were extracted from the medical literature and publicly available national surveys. Men and women between the ages of 18 and 59 were included in our simulated cohort. METHODS: A decision tree model was created to estimate the financial impact of an individual's decision on employment. The outcomes were presented as the cost-savings associated with the following employment statuses over a one-year period: 1) staying full-time, 2) switching from full-to part-time, 3) transitioning from full-time to unemployment, and 4) staying unemployed. CD4 T cell counts and employment statuses were stratified by earned income. Employment probabilities were calculated from national databases on employment trends in the United States. Sensitivity analyses were conducted to test the robustness of the effects of the variables on the outcomes. RESULTS: Overall, the decision outcome that resulted in the least financial loss for individuals with HIV was to remain at work. For an individual with CD4 T cell count > 350, the cost difference between staying employed full-time and switching from full-time to part-time status was a maximum of $2,970. For an individual with a CD4 T cell count between 200 and 350, the cost difference was as low as $126 and as great as $2,492. For an individual with a CD4 T cell count < 200, the minimum cost difference was $375 and the maximum cost difference was $2,253. CONCLUSIONS: Based on our simulated model, we recommend an individual with CD4 T cell count > 350 to stay employed full-time because it resulted in the least financial loss. On the other hand, for an individual with a CD4 T cell < 350, the financial cost loss was much more variable. Our model provides an objective decision-making guide for individuals with HIV to weigh the costs and benefits of employment decisions. Show more

Keywords: Decision-analytic model, CD4 T cell count, salary, direct costs, work-related decision

DOI: 10.3233/WOR-131516

Citation: Work, vol. 44, no. 4, pp. 383-391, 2013

Authors: Tengland, Per-Anders

Article Type: Research Article

Abstract: PROBLEM: We often need to be able to assess the extent to which individuals have or lack work ability. For this we need instruments. Most of the instruments available have flaws. They either lack validity or they use roundabout methods when collecting information about the individual's work ability. OBJECTIVES: The aim of this paper is to present a conceptual model for constructing a questionnaire that can be used for assessing work ability. …METHODS: The methods used are philosophical, i.e. analytical and deductive. A conceptual theory is provided, and based on the resulting definition of the concept of "work ability" conclusions are drawn regarding how to assess work ability. RESULTS: When constructing quantitative instruments, we can increase validity through using a more strict definition of work ability. However, such an approach will only solve some of the problems noted above. The proposal is, instead, to create a qualitative questionnaire, founded on a definition of "work ability", which focuses on the concrete problems concerning the work ability of the individual. Finally, a sketch of such an instrument is provided, with questions covering all the relevant aspects of work ability. CONCLUSION: The qualitative questionnaire proposed is believed to be superior to more traditional (quantitative) instruments for assessing a person's work ability, as well as for finding solutions to her problems concerning work ability. Show more

Keywords: Evaluation, occupational competence, occupational virtues, questionnaire, work tasks

DOI: 10.3233/WOR-2012-1361

Citation: Work, vol. 44, no. 4, pp. 393-404, 2013

Authors: Mendelson, Cindy | Poole, Janet L. | Allaire, Saralynn

Article Type: Research Article

Abstract: OBJECTIVE: Little is known about the physical and discretionary aspects of work that people with scleroderma (SSc) find difficult. This article describes the findings from a study that explored the challenges and adaptations made by individuals with SSc to continue to work. PARTICIPANTS: Thirty-two employed individuals with SSc participated. Participants were predominantly women (82%), white (79%), and well educated (M=16.9 years). The average age was 47.3 years, and 60.6% were married. Mean disease duration …was 9.7 years, and 56.2% had diffuse SSc. Mean years on the job was 10.2 (SD ± 8.8), and 71.9% worked at least 35 hours per week. METHODS: Participants engaged in a single structured interview about work-related challenges and adaptations. Content and thematic analysis was used to identify key themes across the interviews. RESULTS: Employees with SSc experienced Work as a daily challenge. This central theme described the general work experience for most participants. Three subthemes described their specific experiences: The work environment: Opportunities, challenges, and accommodations; Career planning; and Supportive others. CONCLUSIONS: The participants were anxious to find scenarios that allowed them to continue to work. Worksite accommodations and flexibility in scheduling can make the difference between working and disability. Show more

Keywords: Employment, disability, rheumatic disease

DOI: 10.3233/WOR-2012-1420

Citation: Work, vol. 44, no. 4, pp. 405-413, 2013

Authors: Pereira, Cynara Cristina Domingues Alves | López, Ramón Fabian Alonso | Vilarta, Roberto

Article Type: Research Article

Abstract: OBJECTIVE: The physical activity programmes in the workplace (PAPW) are applied to minimize the prevalence, incidence and intensity of pain. This study evaluated the perception of pain and quantifies its intensity among garment workers before and after performing a PAPW. PARTICIPANTS: We included 61 workers of a clothing company, who were classified randomly into experimental group (n=44) 28.7 ± 8.8 years old and a control group (n=17) 27.8 ± 7.4 years (20–43 years). METHODS: The Trigger …Points test questionnaire was used to assess pain perception and quantify its intensity. The PAPW was conducted in 15-minute sessions per day, consisting of stretching exercises (40%), muscular endurance (40%), self-massage relaxation and massage techniques (10%), and group dynamics (10%). RESULTS: The garment workers who participated in the PAPW showed a significant reduction of pain felt in the neck and wrists, and also a reduction in pain intensity in shoulders, arms, fingers and wrists that are most often strained during sewing. CONCLUSIONS: Our findings suggest that PAPW that target muscle groups that are more tense in sewing tasks, may be considered by companies for supporting adaptation to the work environment and improving health by reducing muscle and joint pain. Show more

Keywords: Occupational health, WRMD, work environment, workplace exercises

DOI: 10.3233/WOR-131517

Citation: Work, vol. 44, no. 4, pp. 415-421, 2013

Authors: Kabaroff, J. Lynn | Eys, Mark A. | Schinke, Robert J. | Eger, Tammy

Article Type: Research Article

Abstract: OBJECTIVE: To describe and evaluate the use of a group-mediated cognitive behavioral (GMCB) exercise intervention approach within a corporate environment. PARTICIPANTS: Twenty (n_{males} =17, n_{females} =3) employees from two departments within a large Canadian resource company took part in the study. The average age was 43.50 years (SD=8.60, range=29 to 60) for males and 49.70 years (SD)=6.40, range=45 to 57) for females. METHODS: A mixed methods case study approach was adopted …to assess the response to and effectiveness of the GMCB program within a corporate setting. These included field notes, weekly fitness logs, anthropometric measurements, and end of program focus group sessions. RESULTS: Qualitative measures pointed toward positive outcomes while quantitative results found significant decreases in body mass index, body fat percentage, and waist girth over the duration of the program. Descriptive statistics revealed an increase in exercise frequency and a strong preference for unstructured, group or mixed (i.e., group and individual) based activity during the program. CONCLUSION: The GMCB protocol can be successful at encouraging physical fitness within a corporate environment with the potential to address other health and wellness issues and to aid in vocational team building. Show more

Keywords: GMCB, physical fitness, exercise, organizations

DOI: 10.3233/WOR-2012-1379

Citation: Work, vol. 44, no. 4, pp. 423-433, 2013

Authors: Lexén, Annika | Hofgren, Caisa | Bejerholm, Ulrika

Article Type: Research Article

Abstract: OBJECTIVE: This multiple case study investigated support and process in the Individual Placement and Support (IPS) approach from individual client, longitudinal, and Person-Environment-Occupation (PEO) model perspectives. PARTICIPANTS: Five IPS-participants, or cases, with severe mental illness (SMI) who worked a minimum of 4 hours a week entered the study. METHODS: A multiple data collection method was used over a period of 12 months and included IPS-vocational profiles and plans as well as various instruments and questionnaires concerning …socio-demographics, work performance, limitations, and accommodations. Both within- and across-case analyses were performed. RESULTS: The IPS-process concerned job search support, job-matches (PEO-match), and adjustment of the PEO-match by providing accommodations by on- and off-worksite support. All participants had limitations concerning social interactions and handling symptoms/tolerating stress. Several accommodations were made for the same limitations, mostly directed towards the social environment. Prior work experience, disclosure, and not being in an acute phase of illness seemed important to the support provided. CONCLUSIONS: This study has visualised the support and process in IPS and provided a theoretical framework, the PEO-model, to detect limitations and provide IPS-support. The organization of IPS-support and methods of providing it to individuals may be important for job tenure and employment success. Show more

Keywords: Supported employment, psychiatric disability, PEO-model, work accommodations, vocational rehabilitation

DOI: 10.3233/WOR-2012-1360

Citation: Work, vol. 44, no. 4, pp. 435-448, 2013

Authors: Nilsson, Staffan | Ekberg, Kerstin

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to analyse how people who return to the labour market after long-term sickness absenteeism and subsequent job loss differ in employability, work ability, health, educational level, age, and gender, compared to those who do not. PARTICIPANTS: The cohort consisted of 191 individuals, 20 men and 171 women, whose employment was terminated because they had not been able to return to their regular work after taking a long-term sick leave and …rehabilitation measures. METHODS: This study is based on a postal questionnaire sent out to a cohort of previous employees in a Swedish municipality in 2008. RESULTS: At the time of the survey, 39% of the respondents had returned to the labour market and the remaining 61% had not. Return to the labour market after a long-term sick leave was positively associated with male gender, young age, and work ability, i.e. the ability to work with respect to health and work-related demands. Employability, educational level, and health were not significantly associated with a return to the labour market. CONCLUSIONS: In the discourse on employability, work ability is often neglected even though it is a central aspect of an individual's ability to obtain new employment. Show more

Keywords: Unemployment, health, long-term sick leave, Sweden

DOI: 10.3233/WOR-2012-1402

Citation: Work, vol. 44, no. 4, pp. 449-457, 2013

Authors: Ramel, Eva | Rosberg, Hans-Eric | Dahlin, Lars B. | Cederlund, Ragnhild I.

Article Type: Research Article

Abstract: OBJECTIVES: This paper explores factors important for return to work (RTW) in people who have sustained a serious hand injury. PARTICIPANTS: Forty people aged 19–64, with a severe or major hand injury were recruited consecutively during 2005–2007. METHODS: A self-administered and study specific questionnaire, including demographic data and standardised questionnaires for function, disability, daily occupations, health, quality of life, sense of coherence and several open questions was sent out by mail twelve months after injury. Open …questions regarding RTW were also included. RESULTS: The results showed that 27 people had returned to work within twelve months and 13 had not. Factors related to RTW and general work motivations were divided into individual factors, and factors related to the work environment and rehabilitation. The most prominent differences between the groups were individual factors, such as higher perceived disability, reduced hand function, and dissatisfaction with daily occupations resulting in a lower physical quality of life. The no RTW group had also more ward days (inpatient care) and lower sense of coherence. CONCLUSIONS: These findings support the idea that the RTW process can be more dependent on the person's own ability and motivation than on the severity of the hand injury. Suggestions for intervention and further studies are presented in the discussion. Show more

Keywords: Motivation, daily occupations, disability, sense of coherence

DOI: 10.3233/WOR-2012-1373

Citation: Work, vol. 44, no. 4, pp. 459-469, 2013

Authors: Hillborg, Helene | Danermark, Berth | Svensson, Tommy

Article Type: Research Article

Abstract: OBJECTIVE: One of the challenges agencies and professionals face is to enable people on sick leave to be successful in their vocational rehabilitation. The objective of this study was to explore and analyze some professionals' perceptions of and views about vocational rehabilitation among people with psychiatric disabilities. PARTICIPANTS: Eight professionals from four different agencies (social services, the employment service, the social insurance office, and a psychiatric outpatient setting) working in the area of vocational …rehabilitation for people with psychiatric disabilities. METHODS: Eight in-depth interviews were conducted. The data collected was analyzed using qualitative content analysis together with an interpretive approach. RESULTS: The results suggested the respondents were in consensus regarding that which they considered to facilitate or enable successful vocational rehabilitation. Intensive support over a long period of time and a holistic view that takes into account the habits and routines of daily life outside of work as well as the social and psychological aspects of individuals during their rehabilitation processes were considered to be just as crucial to the vocational rehabilitation process as training in the workplace. CONCLUSIONS: These professionals dealt with a complex vocational rehabilitation system; they felt that their organizations' directives and inability to collaborate successfully with other authorities restricted their scope of action and hindered their exercise of good practice. Show more

Keywords: Mental illness, interagency collaboration, vocational rehabilitation, supported employment

DOI: 10.3233/WOR-131518

Citation: Work, vol. 44, no. 4, pp. 471-480, 2013

Authors: Katz, Noomi | Gilad Izhaky, Smadar | Ziv, Ornit | Revach, Anat

Article Type: Research Article

Abstract: OBJECTIVES: The "Coffee Stands" project was developed to provide a work place where individuals with long term mental illness can receive job training within the community. It is similar to a supported employment program, except that it does not provide individual job placement services. The objective of the study was to describe the participants who worked at the "coffee stands", with respect to their participation in occupations, functional cognition, executive functions and awareness, perception of their …quality of life (QoL), satisfaction and self esteem. Moreover, the study aimed at examining whether changes occurred in these variables during the 6-month period in which participants worked at the coffee stands. METHODS: Participants included 44 people with chronic mental illness; 27 men and 17 women, mean age 43.43 (SD=9.02); mean years of education 11.81 (SD=1.83); mean age of illness onset 27.72 (SD=11.12) and mean number of hospitalizations 3.27 (SD=2.64). All signed an informed consent to participate in the study. A battery of eight instruments measuring the various variables was administered at two points in time; at the beginning of the work at the coffee stands and 6 months later. RESULTS: Indicated that the training was successful and that participants were able to maintain an average 3 hours of work daily, demonstrating an improvement in their perception of their ability to work. In the area of planning, they needed structure, suggesting some difficulties in executive functions, but they seemed to be aware of their difficulties. After 6 months, participants showed improvements in health related measures of QoL and satisfaction, but not in self esteem. CONCLUSIONS: The findings strengthen the premise that people coping with an emotional disorder place great importance on working, are able to work and derive satisfaction from their work. Show more

Keywords: Mental health, schizophrenia, participation, supported employment, work

DOI: 10.3233/WOR-2012-1389

Citation: Work, vol. 44, no. 4, pp. 481-490, 2013

Authors: Achterberg, Thea | Wind, Haije | Prinzie, Peter | Frings-Dresen, Monique

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the inter-rater reliability of the Merkmalprofile zur Eingliederung Leistungsgewandelter und Behinderter in Arbeit (MELBA). PARTICIPANTS: Twenty-five young adults with psychosocial limitations. METHODS: The MELBA measures work ability in five themes: cognitive, social, work performance, psychomotor characteristics and cultural/technical communication, divided into 29 work-related items, which are assessed by work-related tasks and by observations during work performance. Two raters independently evaluated one participant during the same time/test and …independently assigned scores on 19~items out of 29. For this observational study the inter-rater reliability, expressed as the Intraclass Correlation Coefficient (ICC), was calculated for every item. An ICC of at least 0.75 was considered as showing good reliability, below 0.75 was considered poor to moderate reliability. RESULTS: The ICC for six items was good: comprehension (0.81), attentiveness (0.84), problem solving (0.79), imagination (0.88), independence (0.79) and speed of reaction (1.0) showed good reliability. CONCLUSION: Especially the items of cognitive characteristics of the MELBA showed a good inter-rater reliability and can be used to measure work ability in people with psychosocial limitations. Show more

Keywords: Work capacity assessment, intraclass correlation coefficient

DOI: 10.3233/WOR-2012-1363

Citation: Work, vol. 44, no. 4, pp. 491-497, 2013

Authors: Welch, III, Charles E. | Hodgson, Michael J. | Haberfelde, Mimi

Article Type: Research Article

Abstract: OBJECTIVE: Ascertain whether Veterans Health Administration administrative medical center complexity ratings could be used to help identify potential sites for targeted nursing staff workplace violence intervention activities. PARTICIPANTS: VHA field nursing staff, classified among the nurse, practical nurse, and nursing assistant series, who administratively reported a grand total of 9,964 occupational assault incidents that occurred between October 1, 2003 and September 30, 2011. METHODS: Outcome measures were population-based standardized assault …incidence rates, as differentiated by fiscal year, medical facility complexity level, gender, and nursing staff occupation. Subgroup measures included age, highest educational attainment level, location of injury, body part most affected, day of week, and time of day. RESULTS: Across eight fiscal years, standardized incidence rates for reported assaults among females were 6.0 and 2.3 times higher for nursing assistants and practical nurses, respectively, as compared with nurses; for males, the corresponding rates for nursing assistants and practical nurses were 3.5 and 1.5 times higher, respectively. Across occupation and gender, standardized incidence rates for assaults were consistently higher among medium- and low-level facility complexity levels. Findings suggest that more attention is needed for ascertaining the potential role and functioning of facility-specific staff training for preventing assaultive behavior on VHA nursing staff. Show more

Keywords: Workplace violence, occupational injuries, medical facility complexity ratings, violence/prevention and control, violence/statistics and numeric data

DOI: 10.3233/WOR-2012-1479

Citation: Work, vol. 44, no. 4, pp. 499-507, 2013

Authors: Bedno, Sheryl A. | Cowan, David N. | Urban, Nadia | Niebuhr, David W.

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the association of pre-accession physical fitness, as measured by a five-minute step test, with incidence of overuse injuries and outpatient healthcare utilization among male United States (US) Army recruits. PARTICIPANTS: US Army male trainees who met weight standards and took a pre-accession fitness test. METHODS: In this prospective cohort study, incidence and outpatient healthcare visits for overuse injuries during the first 90 days of military service were compared between …recruits who failed the pre-accession step test with those who passed. RESULTS: The hazard rate ratio for injury among recruits who failed the fitness test compared to those who passed the test was 1.31 (95% C.I=1.20–1.44). Among the subset of recruits with at least one medical encounter for an overuse injury, the utilization rate ratio for subjects who failed the fitness test versus those who passed was 1.15 (95% C.I=1.09–1.22). Other factors associated with increased risk of injury or healthcare utilization include age, body mass index, and smoking history. CONCLUSIONS: Risk of injury and utilization were associated with fitness test results. These findings may have implications for military accession and training policy as well as for other physically demanding training programs such as police, fire fighters and athletes. Show more

Keywords: Musculoskeletal injury, military, healthcare utilization, step test

DOI: 10.3233/WOR-2012-1355

Citation: Work, vol. 44, no. 4, pp. 509-515, 2013

Article Type: Other

Citation: Work, vol. 44, no. 4, pp. 517-520, 2013

Article Type: Other

Citation: Work, vol. 44, no. 4, pp. 521-523, 2013