Previously published inScandinavian Journal of Occupational Therapy2007; 14: 203–204 (original) (raw)

Return to Work Influenced by Vocational Rehabilitation in a Multidisciplinary Team

SIGURNOST, 2009

Vocational rehabilitation is a process involving all activities that help the disabled person to obtain or retain a suitable employment (Konvencija št. 159, 1987). In the process, medical information about permanent consequences of a disease/injury must be communicated to the institutions from the field of work, health and disability insurance, and the client's actual capacities, his legal rights, as well as the best way to return to work (or retire) must be planned. During this transition the person experiences different roles and relationships towards different institutions (patient, client, rehabilitant, disabled person, insurance policyholder and worker) and has different legal rights and obligations towards them.

Editorial: Rehabilitation in practice

Clinical Rehabilitation, 2010

Clinical Rehabilitation started a new type of article in the journal in 2006, entitled 'Rehabilitation in Practice'. In the next few months the aim is to develop this feature further by publishing a series of invited articles that focus on clinical practice. Primary research literature potentially relevant to routine clinical practice is far too much for any clinician to read, let alone understand, critically appraise and assimilate. Therefore, maintaining up-to-date practice is dependent on practitioners having access to authoritative, systematic, reliable, unbiased, easy-to-read, up-to-date reviews of the literature concerned with the aetiology, pathophysiology, presentation, prognosis, investigation, treatment and management of the large number of disabling disorders they have to deal with.

New roles in rehabilitation ? the implications for nurses and other professionals

Journal of Evaluation in Clinical Practice, 2006

Rationale, aims and objectives The development of rehabilitation and intermediate care services, and roles therein, is part of current UK health policy to meet the demands of the ever-growing older population. One new role is the rehabilitation assistant (RA). This is a generic support worker trained at a basic level in nursing, physiotherapy, occupational therapy and social work who works under the supervision of the referring professionals, to deliver integrated rehabilitation programmes. RAs were introduced in one region in the north-west of England to increase the rehabilitation activity for patients. An empirical qualitative study was recently undertaken to evaluate the impact of the RAs from the perspectives of patients and associated nurses, therapists, managers and the RAs. Methods Fifty-five semistructured interviews were used to collect data, which was then inductively analysed into categories and then themes. The categories included variations in role, benefits of role, acceptance and integration of role, difficulties with role, training and retention. This paper focuses on the benefits and difficulties of the role. Results It was found that patients, professionals and the RAs expressed great satisfaction with the new role. However, barriers to effective rehabilitation were reported owing to ward routines and organizational systems that interrupted and caused inconsistencies with the rehabilitation care programmes for patients. Conclusions If it is agreed that the majority of patients (unless end stage terminally ill, unwilling or unable) could benefit from some degree of rehabilitation, then there is an issue around how such skills could be widely implemented. This paper discusses the barriers to effective rehabilitation, the benefits and drawbacks of looking at new ways of working and the need for a unified approach by all care workers in rehabilitative care.

Barriers to rehabilitation outcome

Scandinavian Journal of Disability Research, 2003

Work directed rehabiiitation is seen in this article as a type of workfare introduced within social insurance. The purpose of introducing workfare into social insurance in Sweden 1992 was to decrease sick leaves through early and active rehabilitation. The article examines why work directed rehabilitation as workfare was not successful. The barriers to rehabilitation outcome discussed in this article are based on the empirical results of three different studies of work directed rehabilitation. Primary obstacles to work directed rehabilitation were found to be changing definitions of work capacity within the regular labor market, inability to influence change in the organization of work, unwillingness of grass-root bureaucrats to accept workfare in public health insurance, and changing attitudes of the Swedish population towards the concept of work capacity.

What Facilitates Return to Work? Patients Experiences 3 Years After Occupational Rehabilitation

Journal of Occupational Rehabilitation, 2011

Objective We have limited knowledge about the specific elements in an occupational rehabilitation programme that facilitate the process leading to return to work (RTW) as perceived by the patients. The aim of the study was to explore individual experiences regarding contributing factors to a successful RTW, 3 years after a resident occupational rehabilitation programme. Methods The study is based on interviews of 20 individuals who attended an occupational rehabilitation programme 3 years earlier. Ten informants had returned to work (RTW) and ten were receiving disability pension (DP). Data were analysed by systematic text condensation inspired by Giorgi's phenomenological analysis. Results The core categories describing a successful RTW process included positive encounters, increased self-understanding and support from the surroundings. While the informants on DP emphasized being seen, heard and taken seriously by the professionals, the RTW group highlighted being challenged to increase self-understanding that promoted new acting in everyday life. Being challenged on self-understanding implied increased awareness of own identity, values and resources. Support from the surroundings included support from peer participants, employer and social welfare system. Conclusion Successful RTW processes seem to comprise positive encounters, opportunities for increased self-understanding and support from significant others. An explicit focus on topics like identity, own values and resources might improve the outcome of the rehabilitation process.

Integrating Psychosocial and Behavioral Interventions to Achieve Optimal Rehabilitation Outcomes

Journal of Occupational Rehabilitation, 2005

Introduction: Psychosocial factors are important contributors to work disability associated with musculoskeletal conditions. The primary objectives of this paper were 1) to describe different psychosocial interventions that have been developed to prevent prolonged work disability, and 2) to identify future research directions that might enhance the impact of programs targeting psychosocial risk factors for work disability. Methods: Selective review of scientific literature on psychosocial and behavioral interventions and work disability. Results: Most prior interventions focused on psychosocial risk factors that exist primarily within the individual (e.g., pain catastrophizing, beliefs, expectancies). Successful disability prevention will require methods to assess and target psychosocial risk factors "outside" of the individual (e.g., interpersonal conflict in the workplace, job stress, etc.) using cost-effective, multipronged approaches. Research to explore interactions among different domains of psychosocial risk factors in relation to RTW outcomes is needed. Challenges to effective secondary prevention of work disability include developing competencies to enable a range of providers to deliver interventions, standardization of psychosocial interventions, and maximizing adherence to intervention protocols. Conclusion: Effective secondary prevention of work disability will require research to develop cost-effective, multipronged approaches that concurrently target both worker-related and workplace psychosocial risk factors.

Developing and Using Evidence to Improve Rehabilitation Practice

Archives of Physical Medicine and Rehabilitation, 2012

The Clinical Practice Committee of the American Congress of Rehabilitation sponsored this supplement to address 2 critical, related issues for the rehabilitation field: how to develop clinical rehabilitation research to generate useful, high-quality evidence and how to use evidence to improve rehabilitation practice. The 2 are linked by the methods of evidence-based practice (EBP) used to evaluate research evidence and make recommendations for practice. Supplement authors tackle challenges, such as identifying treatment effects and how study design decisions can impact the internal and external validity of research findings, in 4 articles that describe: a 3-phase process for the development of rehabilitation treatments; small-N study designs; the design, implementation, and statistical analysis of rehabilitation clinical trials; and observational research designs used to compare the effectiveness of rehabilitation treatments. Two articles present contemporary best methods for developing and evaluating rehabilitation prediction models and outcome measures. The supplement also addresses issues of evaluating research evidence and translating evidence into clinical decisions or recommendations. An overview of tools that EBP adherents have developed to help the clinician find, synthesize, and apply evidence is presented, followed by an article that identifies 8 primary steps in the production of a systematic review. The last article outlines 13 recommendations for improving systematic evidence reviews and applying their resulting knowledge to clinical practice. In addition to recommending best methods, the supplement addresses challenges specific to the behavioral complexity of developing rehabilitation research and applying it in a way that improves the health, function, and quality of life of persons served.