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This article analyses the Tapering of Benefits scheme introduced in Malta in 2014, aimed at unlocking the poverty trap stalemate. Survival analysis and Cox proportional hazard models are employed to analyse the impact that the scheme has had on the job‐finding rate and the chances of retaining employment once individuals who were previously on benefits find a job. The analyses are based on high‐quality national data on the whole population of beneficiaries and their employment histories. The results show that the scheme doubles the job‐finding probability, whilst the chance of job termination drops by 11.8 percentage points for eligible individuals. Furthermore, the scheme's impact once it finally tapers out is not different from the first 36 months, showing that its impact is robust in the medium term. [ABSTRACT FROM AUTHOR]

Concerns about whether highly educated daughters of non-Western immigrants will make use of their education after family formation or will instead follow a gender-based division of labour and childcare have been raised in Western Europe. Drawing on theoretical arguments from human capital theory, socio-cultural approaches and mechanisms of the 'immigrant drive,' this study investigates work re-entry following childbirth among highly educated descendants of immigrants from Vietnam and Pakistan. By exploiting unique population-based data from Norwegian public registers, Cox proportional hazards regressions show that descendants of Pakistani immigrants are less likely to return to work following childbirth. However, the difference between daughters of Pakistani immigrants and their native peers is no longer statistically significant when looking at return to full-time work. The chance of returning to work per se among descendants of Vietnamese immigrants does not differ from native majority women. Consistent with the literature, this study demonstrates that education level is probably the most important determinator for return to work following childbirth—irrespective of immigrant background. Overall, the results indicate that the highly educated descendants of immigrants are similar to their highly educated majority peers in organising their working life and childcare in the gender-egalitarian Norwegian welfare state. [ABSTRACT FROM AUTHOR]

Introduction A great deal of time and resources have been spent on developing and implementing evidence-based return to work programs over the past few decades, compelling researchers to better understand the factors associated with more favorable outcomes. Using data collected as part of a participant tracking system trial for the Canadian Armed Forces (CAF) Return to Duty (RTD) program, analyses were conducted to better understand the trajectories of program participants and identify the factors associated with RTD. Materials and Methods Participants included 205 Regular Force CAF members from a single military base located in Eastern Canada who entered the RTD program during the trial period between April 2018 and March 2020. The health condition they were facing was mostly recent (i.e. onset within the past 6 months; 43%) and involved their mental health (67%). Data were collected on various demographic, military, health, and program characteristics using the RTD Data Collection Tool, which was updated periodically by program coordinators. Using data gathered by the Tool, a cumulative incidence function was generated to estimate the overall marginal probability of RTD over the duration of the program. Associations between RTD and a range of factors that were captured using the Tool were also examined in a series of competing-risks regressions. Results Findings indicated that the rate of RTD among program participants increased at around 3 months and began to level off around 9 months, suggesting that the likelihood of RTD after this window is diminished. Of the many factors that were considered, only years of service and work placement status at 3 months were found to be associated with RTD. Specifically, lower rates of RTD were observed among participants with 15 or more years of service compared to those with less than 5 years of service in the CAF and among those who were not yet assigned a work placement at 3 months relative to those who were. Conclusion This study represents a first step in addressing the gap in our current knowledge about the characteristics of CAF members participating in the RTD program and the factors associated with RTD. Several recommendations are made for improving the participant tracking system in view of enhancing the level and quality of information that is available to assess participants' trajectories and inform further development of the program. [ABSTRACT FROM AUTHOR]

Objective: Quality of performance after stroke in working-active survivors has been poorly studied. The aim of this study is to analyze work performance after stroke not only by the probability of being active in daily job activities but also by the survivor's ability to recover capability in different cognitive and motor areas. Material and methods: We developed a 15-item survey for stroke who had returned to their work activity. The survey evaluated 11 different domains (language, memory, attention, planning, calculating, writing, motor skills, gait, visual, mood, and self-perception). Internal consistency, test-retest reliability, item-scale correlation, and factor analysis were conducted. Results: A total of 100 ischemic stroke survivors were recruited (51 [51.0%] female patients, median age 42 years [interquartile range = 34.5-54.5 years]); median time to return to work was 4 months. Work performance after stroke was high in 16% of cases, good in 58% of cases, moderate in 24%, and low in 2%. Chronbach's alpha coefficient was 0.75 for the scale. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.72 (p < 0.001). The test-retest reliability, as estimated by the intraclass correlation coefficients, was good. Memory, language, and attention explained 59.7% of the variance of the questionnaire in the extraction analysis. Conclusion: The WPQ-INNN is a reliable and valid tool for the assessment of performance quality in stroke survivors who returned to work. [ABSTRACT FROM AUTHOR]

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Background: Limited research and studies prove the usefulness of case management for persons with disabilities, which helps disabled employees recover their dignity through medical vocational, and psychological rehabilitation in underdeveloped countries' Return To Work (RTW) programs. Methods: This qualitative case study design involved semi structured interviews with case managers as the primary data source, supplemented by secondary data from BPJS Ketenagakerjaan. Data analysis utilized QDA Miner Lite and Python with ArcGIS integration for descriptive visualization. Results: The RTW program of BPJS Ketenagakerjaan has already adopted ILO's fundamental suggestion, which creates two central themes: internal aspects that are essential to the RTW framework and external variables that impact RTW practice. The key themes produce six main pieces to discuss further: personal skill, personal literacy, providers, guidelines, authorities, and stakeholder support. Conclusion: Return to Work Program benefits companies, and the implementation of a career development service or a partnership with non-governmental organizations guarantees that disabled employees who cannot return to work with their former employers are still in the global economy. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to develop an approach to predict hand posture (pinch versus grip) and grasp force using forearm surface electromyography (sEMG) and artificial neural networks (ANNs) during tasks that varied repetition rate and duty cycle. Background: Prior studies have used electromyography with machine learning models to predict grip force but relatively few studies have assessed whether both hand posture and force can be predicted, particularly at varying levels of duty cycle and repetition rate. Method: Fourteen individuals participated in this experiment. sEMG data for five forearm muscles and force output data were collected. Calibration data (25, 50, 75, 100% of maximum voluntary contraction (MVC)) were used to train ANN models to predict hand posture (pinch versus grip) and force magnitude while performing tasks that varied load, repetition rate, and duty cycle. Results: Across all participants, overall hand posture prediction accuracy was 79% (0.79 ±.08), whereas overall hand force prediction accuracy was 73% (0.73 ±.09). Accuracy ranged between 0.65 and 0.93 based on varying repetition rate and duty cycle. Conclusion: Hand posture and force prediction were possible using sEMG and ANNs, though there were important differences in the accuracy of predictions based on task characteristics including duty cycle and repetition rate. Application: The results of this study could be applied to the development of a dosimeter used for distal upper extremity biomechanical exposure measurement, risk assessment, job (re)design, and return to work programs. [ABSTRACT FROM AUTHOR]

Background Increasing cancer screening rates among working-age populations and providing employment support for employees with cancer are issues that need to be addressed in Japan. Therefore, this study aimed to clarify the situation regarding cancer screening promotion and employment support for employees with cancer at business establishments and the support they seek from medical professionals regarding these issues. Methods This survey covered 1,058 business establishments and included the following items: attributes of the business establishments, cancer screening rate, support for employees to promote cancer screening, support sought by business establishments from medical professionals to promote cancer screening, presence of employees with cancer, support programs for employees with cancer, awareness of the resources available for employment support for employees with cancer, difficulties in supporting employees with cancer in the workplace, and support sought by business establishments from medical professionals in providing employment support for employees with cancer. Data analysis was primarily conducted using summary statistics. Results This study included 153 establishments. The median cancer screening rate ranged from 50.00 to 99.15. Employee support for promoting cancer screening ranged from approximately 30% to 40% for "ensuring time for screening" and from 20% to 30% for "providing full subsidies for cancer screening cost." The median screening rate for breast and cervical cancers was 50.00, and support for promoting screening was less than 30% for each. Business establishments sought support from medical professionals regarding cancer and study sessions on cancer prevention to promote cancer screening. Regarding support systems for employees with cancer, 49.7% of the establishments offered sickness benefits, and 42.5% offered paid leave on an hourly basis. Less than 10% were aware of the websites provided by public organizations regarding employment support for patients with cancer. Approximately 50% of the establishments reported difficulties regarding treatment policies and duration uncertainties. Conclusion Business establishments sought the provision of relevant knowledge and specific information to increase cancer screening rates and provide employment support for employees with cancer. Furthermore, this study suggests that employees with cancer need to manage the information they provide their establishments. [ABSTRACT FROM AUTHOR]

The Ticket to Work (TTW) program was established by 1999 legislation to expand access to vocational rehabilitation services for beneficiaries of Social Security Administration (SSA) disability benefit programs. We evaluate TTW and compare its outcomes with the intentions of its authorizing legislation. We also compare the program's costs with the benefit savings resulting from the reemployment of successful program participants. We analyze unadjusted descriptive statistics, then consider potential participation bias among individuals who received employment services by devising an econometric analysis that accounts for the seriousness of a participant's interest in work. We find that TTW improved employment outcomes and generated net benefit savings to SSA for many employment-service clients, but the savings did not fully offset program costs. However, these estimates should be regarded as lower bounds of TTW's positive effects because they do not account for higher service needs of TTW program participants. [ABSTRACT FROM AUTHOR]

Background: Using XGBoost (XGB), this study demonstrates how flexible machine learning modelling can complement traditional statistical modelling (multinomial logistic regression) as a sensitivity analysis and predictive modelling tool in occupational health research. Design: The study predicts welfare dependency for a cohort at 1, 3, and 5 years of follow-up using XGB and multinomial logistic regression (MLR). The models' predictive ability is evaluated using tenfold cross-validation (internal validation) and geographical validation (semi-external validation). In addition, we calculate and graphically assess Shapley additive explanation (SHAP) values from the XGB model to examine deviation from linearity assumptions, including interactions. The study population consists of all 20–54 years old on long-term sickness absence leave due to self-reported common mental disorders (CMD) between April 26, 2010, and September 2012 in 21 (of 98) Danish municipalities that participated in the Danish Return to Work program. The total sample of 19.664 observations is split geospatially into a development set (n = 9.756) and a test set (n = 9.908). Results: There were no practical differences in the XGB and MLR models' predictive ability. Industry, job skills, citizenship, unemployment insurance, gender, and period had limited importance in predicting welfare dependency in both models. On the other hand, welfare dependency history and reason for sickness absence were strong predictors. Graphical SHAP-analysis of the XGB model did not indicate substantial deviations from linearity assumptions implied by the multinomial regression model. Conclusion: Flexible machine learning models like XGB can supplement traditional statistical methods like multinomial logistic regression in occupational health research by providing a benchmark for predictive performance and traditional statistical models' ability to capture important associations for a given set of predictors as well as potential violations of linearity. Trial registration: ISRCTN43004323. [ABSTRACT FROM AUTHOR]

Objective: To describe the rate and factors related to nonreturn to work in the third month after discharge from the intensive care unit and the impact of unemployment, loss of income and health care expenses for survivors. Methods: This was a prospective multicenter cohort study that included survivors of severe acute illness who were hospitalized between 2015 and 2018, previously employed, and who stayed more than 72 hours in the intensive care unit. Outcomes were assessed by telephone interview in the third month after discharge. Results: Of the 316 patients included in the study who had previously worked, 193 (61.1%) did not return to work within 3 months after discharge from the intensive care unit. The following factors were associated with nonreturn to work: low educational level (prevalence ratio 1.39; 95%CI 1.10 - 1.74; p = 0.006), previous employment relationship (prevalence ratio 1.32; 95%CI 1 10 - 1.58; p = 0.003), need for mechanical ventilation (prevalence ratio 1.20; 95%CI 1.01 - 1.42; p = 0.04) and physical dependence in the third month after discharge (prevalence ratio 1.27; 95%CI 1.08 - 1.48; p = 0.003). Survivors who were unable to return to work more often had reduced family income (49.7% versus 33.3%; p = 0.008) and increased health expenditures (66.9% versus 48.3%; p = 0.002). compared to those who returned to work in the third month after discharge from the intensive care unit. Conclusion: Intensive care unit survivors often do not return to work until the third month after discharge from the intensive care unit. Low educational level, formal job, need for ventilatory support and physical dependence in the third month after discharge were related to nonreturn to work. Failure to return to work was also associated with reduced family income and increased health care costs after discharge. [ABSTRACT FROM AUTHOR]

Introduction: Following acquired brain injury, the goal of return to work is common. While return to work is supported through different rehabilitation models and services, access to vocational rehabilitation varies within and between countries, and global rates of employment post-injury remain low. The literature identifies outcomes from vocational programs and experiences with return to work, yet little is known about individuals' perceptions and experiences regarding rehabilitation to support their vocational goals and experiences in attempting to return to work. Method: This qualitative study investigated the experiences of community-living adults with acquired brain injury (n = 8; mean age 45 years; mean time post-injury of 5.5 years) regarding their vocational rehabilitation and return to work. Focus groups and semi-structured interviews were conducted, with data analyzed via thematic analysis. Results: Participants identified negative and positive experiences with vocational rehabilitation and return to work. Five overarching themes were identified: addressing vocational rehabilitation in rehabilitation; facilitators of recovery and return to work; the importance and experience of working again; acquired brain injury and identity; and services, systems and policies. Participants also identified five key areas for early vocational rehabilitation services: education; service provision; employer liaison; workplace supports; and peer mentors. Study findings inform current and future practice and service delivery, at a clinical, service and system level. [ABSTRACT FROM AUTHOR]

Background: An injury followed by surgery poses many challenges to an athlete, one of which is rehabilitation, with the goal of returning to sport. While total restoration of physical abilities is a primary goal for most athletes, psychosocial factors also play an important role in the success of an athlete's return to sport (RTS). The purpose of this review was to examine the effectiveness of exercise and psychosocial interventions on RTS rates, which might be one of the most important outcomes for elite athletes. Methods: To carry out this review, PubMed, SAGE Journals, Web of Science, SPORTDiscus, ScienceDirect, and Google Scholar databases were searched frominception to July 2022. The inclusion criteria consisted exercise or psychosocial intervention for athletes after anterior cruciate ligament reconstruction (ACLR), with reporting RTS rates as an outcome. Results: From 1032 identified articles, four reports (N = 130) met inclusion criteria, all of which examined the recovery after ACLR. The mean MINORS score for the included studies was 16.3 ± 6.1, of which non-comparative studies scored 11.0 ± 1.4, while comparative studies scored 21.5 ± 0.7. There were consistent findings for benefits of exercise and psychosocial interventions on RTS rates. Return to preinjury rates in the reviewed studies vary between 63 and 95% with lower % observed in female athletes and with shorter follow-up. Interventional studies reporting RTS rates with a larger sample size and longer follow-up are needed. Conclusion: Physical and psychological function, as well as social support can be influenced by appropriate interventions, indicating future work on rehabilitation programs for return to preinjurymight consider taking the holistic approach addressing those. [ABSTRACT FROM AUTHOR]

In the Scandinavian countries, social insurance officers (SIOs) hold key positions with regard to coordinating the return‐to‐work (RTW) process of workers on long‐term sick‐leave. This article aimed to systematically explore the experience of encounters between the sick‐listed and SIOs and set out the current scientific knowledge base on factors related to the encounter that are perceived as having an impact on the sick‐listed's RTW. A scoping review was conducted that included peer‐reviewed articles published in the English language in the period January 2000 to February 2021. Of the 435 articles reviewed to determine eligibility, 38 were included. Most of the articles included were qualitative (68%) and focused on the sick‐listed's experience of encounters with RTW professionals. The main finding of this review is that the majority of the sick‐listed perceived the encounters with SIOs as positive. The perspective of SIOs was less subject to study, and the research focus was more often concerned with practical aspects of the encounter, such as stakeholder cooperation and the impact of policy on SIOs' working conditions. Furthermore, we found that SIOs experience challenges in stakeholder cooperation and in performing workability assessments, especially where objective medical information is scarce. The findings of this review suggest that future studies should pay more attention to the SIO perspective in encounters between sick‐listed and SIOs. [ABSTRACT FROM AUTHOR]

The Return to Work (RTW) Program has been in place since 2007 by the Social Security Organisation (SOCSO) Malaysia in response to an increase in the number of commuting accident cases, invalidity claims, the financial instability of social security funds, and the length of time that are disabled. In order to reintegrate injured workers back into society, the programme provides resources for physical and occupational rehabilitation. Thus, assessing their suitability for formal employment is crucial before assisting them in returning to work. This research aimed to see if there was a link between employment readiness and the likelihood of RTW among participants in SOCSO's Malaysia RTW programme. The study used a descriptive quantitative research design. From January to December 2017, all data for 705 participants recommended for the RTW Program was collected from SOCSO personal electronic files. The Lam Assessment on Stages of Employment Readiness (LASER) was used to measure employment readiness of Action, Contemplation, and Pre-Contemplation stages. Data on sociodemographics, employment readiness stages, and the time it took to return to work were analysed. T-Test and ANOVA were used to assess the difference between demographic characteristics and employment preparedness with the pace to RTW. A total of 407 people were able to return to work, with more than half of them doing so in less than 90 days. More than half of respondents (60%) in the Pre-Contemplation and Action stage and 63% of the contemplation stage participants returned to work. According to the findings, there is no statistically significant difference in group means, which contradicts earlier research. The correlation between readiness and RTW duration was also analysed, but no significant association was discovered. Recognising the RTW scenario in Malaysia, more research is needed to examine the assessment management and other RTW predictive factors. The attitudes and behaviours of RTW were also not adequately explored in this study, which should be addressed in future research. [ABSTRACT FROM AUTHOR]

Background: This study aimed to understand Canadian cancer survivors' experiences during the return-to-work (RTW) process. Methods: A prospective qualitative longitudinal design was employed using the principles of phenomenological inquiry. Cancer survivors took part in three in-depth interviews: at the end of treatment, and 3 and 9 months after the first interview. Transcripts were analyzed using constant comparative analysis, guided by the Cancer and Work model. Results: A total of 38 in-depth interviews were conducted with 13 participants. The resultant themes were: (1) supports received or desired to enable RTW; (2) others' limited understanding of the long-term impacts of a cancer diagnosis and its treatment; (3) worries and self-doubts about returning to work; and (4) changing perspectives on life and work after cancer. Conclusions: Cancer patients returning to work after treatment often experience challenges throughout the process, including varying levels of support from others and a range of ongoing effects and motivation to RTW. There is a clear gap in terms of the professional supports available to these individuals. Future research should focus on investigating how to improve both quality and accessibility of supports in a way that is personalized to the individual. [ABSTRACT FROM AUTHOR]

Background: Independent medical evaluations are used to evaluate degree and reason for work disability, uncertainty around the functional status, and/or the employee's rehabilitation potential in several jurisdictions, but not in Norway. The main aim of this trial was to test the return to work effect of independent medical evaluation (IME) (summoning and consultation) compared to treatment as usual (TAU) in Norway, for workers who have been on continuous sick leave for 6 months.Methods: This was a pragmatic randomised controlled trial including all employees aged 18-65 years, sick-listed by their general practitioner and on full or partial sick leave for the past 26 weeks in Hordaland County, Norway in 2015/16. Trial candidates were drawn from a central register at the Norwegian Labour and Welfare Administration at 22 weeks of sick leave. Pregnant women, individuals with cancer or dementia diagnoses, those with secret address, employed by NAV or sick listed by the specialist health services were excluded. Separate regression analyses were conducted to investigate the "intention-to-treat" and "treatment on the treated" effects, using the ordinary least squares and instrumental variable methods, respectively.Results: After exemption based on predefined exclusion criteria, 5888 individuals were randomised to either IME (n = 2616) or TAU (n = 2599). The final intervention group constitutes 1698 individuals, of which 937 attended the IME consultation. No baseline differences were found between the IME and TAU group regarding gender, age, and previous sick leave. Individuals attending the IME were older than those who cancelled the appointment ((47/45), p = 0.006) and those who did not show up without cancelling ((47/42), p < 0.001). Mainly the IME physician agreed with the regular GP upon level of sick leave. In cases with different assessments, the difference tended to be towards a lower sick leave level. There were no intention to treat or treatment on the treated effect on days of sick leave after randomisation during follow up.Conclusions: Overall, the analyses showed no effect of IME on changes in sick leave for sick listed employees. This result was consistent for those who were offered an IME consultation (intention to treat) and those who undertook an IME consultation (treatment on the treated).Trial Registration: ClinicalTirals.gov trial number NCT02524392 first registration 14.08.2015. [ABSTRACT FROM AUTHOR]

Purpose: Work can offer a myriad of social and health benefits. Long-term sick leave can be detrimental to employers, individuals, families, and societies. The burden of long-term sick leave has motivated the development of return to work (RTW) interventions. This study sought to determine what constitutes an effective psychosocial RTW intervention, which included exploring whether the level of intervention intensity and intervention characteristics matter to RTW outcomes.Methods: A systematic review and narrative synthesis were undertaken. Studies were identified through six databases (Ovid Medline, CINAHL (EBSCOhost), PsycInfo (Ovid), ProQuest, Scopus, and Google Scholar) between 2011 and 3 September 2019. Randomised controlled trials (RCTs) or reviews published in English were eligible for inclusion if they targeted adults who were on sick leave/unemployed trying to return to full-capacity employment, had at least one structured psychosocial RTW intervention, and assessed RTW. Study quality was assessed using checklists from the Joanna Briggs Institute.Results: Database searching yielded 12,311 records. Eighteen RCTs (comprising 42 intervention/comparison groups), seven reviews (comprising 153 studies), and five grey literature documents were included. Included studies were of moderate-to-high quality. Research was primarily conducted in Europe and focused on psychological or musculoskeletal problems. RTW outcomes included RTW status, time until RTW, insurance claims, and sick days. Participating in a RTW program was superior to care-as-usual. RTW outcomes were similar between diverse interventions of low, moderate, and high intensity. Common foundational characteristics seen across effective RTW interventions included a focus on RTW, psychoeducation, and behavioural activation.Conclusions: Evidence suggests that a low intensity approach to RTW interventions may be an appropriate first option before investment in high intensity, and arguably more expensive interventions, as the latter appear to provide limited additional benefit. More high-quality RCTs, from diverse countries, are needed to provide stronger evidence. [ABSTRACT FROM AUTHOR]

Background: This study examined how meeting the medical needs of injured workers after initial treatment may affect their return to work, using data from the Panel Study of Workers' Compensation Insurance.Methods: This study was designed as a longitudinal study, which used data from the second-year, follow-up survey conducted in the secondary cohort of the Panel Study of Workers' Compensation Insurance. The odds ratio (OR) and 95% confidence interval were estimated through binomial and multinomial logistic regression analyses to examine the effects of unmet medical needs on workers' return to original work and return to work overall (including reemployment).Results: The returned to original work OR of workers whose rehabilitation needs were met was 1.35 (1.12-1.63) while the return to work OR was 1.20 (1.03-1.41). The returned to original work OR of workers whose medical needs were met was 1.64 (1.18-2.27) while the return to work OR was 1.39 (1.07-1.80). In terms of disability rating, the return to work ORs of workers with mild disabilities whose medical/rehabilitation needs were not met and those of workers without disabilities were 1.71 (1.17-2.49) and 1.97 (1.27-3.08), respectively. In the case of regular/temporary workers, the returned-to-work ORs of workers whose medical/rehabilitation needs were not met were 1.54 (1.12-2.13) and 1.27 (1.03-1.56), respectively.Conclusions: For workers who sustained work-related injuries, providing medical accessibility and meeting rehabilitation needs were found to be important predictors of return to work after initial treatment. [ABSTRACT FROM AUTHOR]

Background: Sick-leave due to COVID-19 vary in length and might lead to re-current episodes. The aim was to investigate recurrent sick leave due to COVID-19 during the first wave.Methods: This is a registry-based cohort study. The study comprises all people with sickness benefit due to COVID-19 in Sweden in March 1-August 31, 2020. Data from the Swedish Social Insurance Agency, the Swedish National Board of Health and Welfare, and Statistics Sweden were merged.Results: Within the follow-up period of 4 months, 11,955 people were subject to sickness benefit due to COVID-19, whereof 242 people (2.0%) took recurrent sick leave due to COVID-19, and of those 136 (56.2%) remained on sick leave at the end of follow-up. People with recurrent sick leave were older, more often women, and more likely to have been on sick leave prior to the COVID-19 pandemic.Conclusion: A group of people presented with recurrent sick leave due to COVID-19. For half of them, the second sick leave lasted throughout the follow-up. People with recurrent sick leave differ in several aspects from those with shorter sick leave. To capture long-term sick-leave patterns due to COVID-19, a longer period of follow-up is needed. [ABSTRACT FROM AUTHOR]

Background: Primary liver cancer is the fifth most common malignancy and limits patients' quality of life and working ability. Return to work after cancer treatment is an important step in social recovery. In addition, return to work represents the recovery of financial ability and improvements in self-confidence. The purpose of this article is to discuss the relationship between return to work and various covariables in workers with liver cancer.Methods: The national registry cohort study collected adult workers newly diagnosed with liver cancer from 2004 to 2010 in Taiwan. There were 2451 workers included in our study. Primary liver cancer was diagnosed by using the International Classification of Diseases for Oncology code. Return to work after liver cancer survival was determined as returning to the same work or reemployment within five years after cancer diagnosis. The associations between independent variables and return to work were analyzed by Cox proportional hazard models.Results: Workers who underwent surgery were more likely to return to work not only in the 2nd year but also in the 5th year. A lower survival rate was noted in the non-return-to-work group (p < 0.001) among all patients with liver cancer. The completely adjusted model identified that the rate of return to work was related to all-cause mortality with a hazard ratio of 0.244 (95% Confidence Intervals: 0.235-0.253).Conclusions: Our study indicated the impacts of treatment on the return to work of liver cancer survivors. In addition, in patient with liver cancer, return to work had positive effect on the survival rate. [ABSTRACT FROM AUTHOR]

Background: Many cancer survivors experience physical and/or psychosocial problems affecting return to work (RTW) and work retention. Current interventions on RTW lack evidence regarding effectiveness, while interventions for work retention are missing. Partners of cancer survivors may also experience work- and health-related outcomes; yet, these consequences are not well understood. Here, the protocol of the STEPS study is described. The study aims are to: 1) evaluate the (cost-)effectiveness of a rehabilitation program for RTW and work retention in cancer survivors, and 2) assess health- and work-related outcomes among cancer survivors' partners.Methods: In a multicentre Randomized Controlled Trial (RCT), 236 working-age cancer survivors with an employment contract will be randomly allocated to a usual care group or an intervention group receiving a multidisciplinary rehabilitation program, combining occupational therapy facilitating work retention (e.g., energy management and self-efficacy training) and reintegration consultation addressing work-related issues (e.g., RTW planning and discussing workplace or task modifications with the supervisor). Alongside the RCT, a prospective cohort study will be conducted among cancer survivors' partners (n = 267). Participants in the RCT and cohort study will be asked to complete questionnaires at baseline, and after six and 12 months, assessing work- and health-related outcomes. Generalized estimating equations will be used to assess intervention's effectiveness, compared to usual care, regarding primary (i.e., working hours per week) and secondary outcomes. Also economic and process evaluations will be performed. For the cohort study, logistic or linear regression modelling will be applied assessing work- and health-related outcomes (primary outcome: working hours) of cancer survivors' partners, and what factors predict these outcomes.Results: The study is planned to start in September 2021; results are expected in 2023.Conclusion: Compared to usual care, the STEPS intervention is hypothesized to be (cost-)effective and the intervention could be a valuable addition to standard care helping cancer survivors to sustain employment. Further, it is expected that living with a cancer survivor has a substantial impact on work and health of partners, while specific groups of partners that are at particular risk for this impact are likely to be identified.Trial Registration: Dutch Trial Register ( NTR;NL9094 ; 15-12-2020). [ABSTRACT FROM AUTHOR]

Background: Earlier studies indicate a correlation between disability claims experience and return to work outcomes. Thus, the insurer's role and actions may affect the self-rated health of the disabled worker and the outcomes of occupational rehabilitation. This study diversifies the existing empirical evidence on the role of the insurer in the rehabilitation process and reveals the critical actions that best promote success.Materials and Methods: Explorative factor analysis (EFA) and confirmatory factor analysis (CFA), followed by binary regression, were used to analyse survey data of disabled workers (n = 661) who had undergone an occupational rehabilitation within an earnings-related pension insurance system in Finland.Results: The claimant's perceptions of the insurer's (1) high-quality informing and guidance, (2) customer orientation, (3) smooth process flow and (4) positive service attitude had substantial and statistically significant effects on the success of occupational rehabilitation after adjusting for all likely confounding variables.Conclusions: The insurer's actions are significant predictors of the outcome of occupational rehabilitation. The insurer can promote the health of rehabilitees most effectively by ensuring a smooth process flow and adopting a customer-oriented approach. [ABSTRACT FROM AUTHOR]

Despite a recent dramatic increase in the rate of employer accommodation of injured workers, the extant literature provides little evidence on the determinants of accommodation or the reasons for this upward trend. In this study, the authors take a comprehensive approach to estimating the determinants of workplace accommodation, assessing the influence of employer workers’ compensation (WC) costs; WC market features and state WC laws; and characteristics of firms, injured workers, and their injuries. Using state-level data from the BLS, they find that employer WC costs, WC market features, and state return-to-work (RTW) policies all have an impact on accommodation, but the effects are small and explain only one-fifth of the increase in restricted work. With data on injured workers from the NLSY79 and HRS, the authors study case-specific determinants of accommodation. Results suggest that employer and injury characteristics matter most, and these results are consistent with accommodation occurring mostly at large, experience-rated employers. [ABSTRACT FROM PUBLISHER]

Background: Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained.Methods: A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter.Results: Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures.Conclusions: With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention.Trial Registration: The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ). [ABSTRACT FROM AUTHOR]

Background: Exhaustion disorder (ED) is a common cause of sick leave in Sweden, and patients often have long-lasting symptoms and reduced work capacity. The aim of this study was to explore whether patients with ED had made any changes in their work situation from the period of treatment and up to 7 years later.Methods: In this cross-sectional study, patients diagnosed with ED at a specialist outpatient clinic were followed up after 7 years (n = 217). They received questionnaires at baseline covering sex, age, marital status, level of education, and symptoms of burnout, depression, and anxiety measured with the Shirom-Melamed Burnout Questionnaire and the Hospital Anxiety and Depression Scale. After 7 years, they were sent a follow-up questionnaire asking about their work situation and work-related stressors both before they fell sick and at the 7-year follow-up. There were three questions on work situation (change of workplace, change of work tasks, and change of working hours), and 155 patients responded to all three.Results: After 7 years, the majority of the patients (63%; n = 98/155) reported that they had made some kind of change at work. Women were more likely than men to report decreased working hours (p = 0.001), and work-related stressors such as conflicts at work, reorganization, deficient leadership, and general discontent with the work situation were significantly more common at baseline in the group who had made changes at work. Patients who made no changes at work experienced more work-related stress due to quantitative demands in the 7-year follow-up.Conclusion: The majority of the patients with ED made some kind of change in their work situation, and gender differences were found for changes of work tasks and working hours. Work-related stressors might be decisive for making changes at work. [ABSTRACT FROM AUTHOR]

Background: Both the presence of psychological problems and the absence of an employment contract are related to long-term sickness absence, prolonged work disability and unemployment. Studies researching the effectiveness of return-to-work interventions on these non-permanent workers, including unemployed and temporary agency workers and workers with an expired fixed-term contract, are lagging behind. Therefore, a return-to-work intervention called "Brainwork" was developed. The aim of this study was to assess the effectiveness of the 'Brainwork Intervention' in reducing the duration of sick leave compared to usual care over a 12-month follow-up.Methods: In a multicenter controlled clinical trial, using a quasi-randomization procedure, we compared the Brainwork Intervention (n = 164) to usual care (n = 156). The primary outcome was the duration of sick leave. Secondary outcomes were the duration of sick leave starting from Social Security Agency transfer; the proportion of workers returned to work; the number of hours of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. Protocol adherence (Brainwork Intervention) was considered sufficient when at least three of the five protocol steps were followed. Cox regressions, linear and ordinal regression, and Mixed Model analyses were performed.Results: All 320 participants were analyzed. The Brainwork Intervention resulted in a non-significant reduction of the duration of sick leave compared to usual care (269 days versus 296 days; HR = 1.29; 95% CI 0.94-1.76; p = 0.11). For those working (46%) during the 12-month follow-up, the mean number of hours of paid employment was non-significantly higher in the usual care group (682 h versus 493 h; p = 0.053). No significant differences were found for other secondary outcomes. Protocol adherence was 10%.Conclusions: The Brainwork Intervention as performed with a low protocol adherence did not result in a significant reduction of the duration of sick leave compared to usual care. It remains unclear what the results would have been if the Brainwork Intervention had been executed according to protocol.Trial Registration: The Netherlands Trial Register (NTR); NTR3976 (old registration number NTR4190). Registered September 27th 2013. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia.Methods: This inception cohort study followed 2019 people injured in MVCs, for 6 and 12 months post-injury. We categorised moderate injury as hospital length-of-stay (LOS) of 2-6 days and Injury Severity Score (ISS) of 4-11, while severe injury as LOS ≥7 days or ISS ≥ 12. We examined differences in paid work status, 12-Item Short Form Survey (SF12), EQ-5D and World Health Organisation Disability Assessment Schedule II (WHODAS) outcomes longitudinally from baseline to 12 months between levels of injury severity using linear mixed models for repeated measures. We first considered minimally sufficient adjustment factors (age, sex, crash role, perceived danger in crash, pre-injury health, pre-injury EQ-5D, recruitment source), and then more extensive adjustments including post-injury factors. The presence of mediating pathways for SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) via post-injury factors was evaluated.Results: Based on hospital length of stay (LOS), 25 and 10% of participants sustained moderate and severe injuries, respectively, while 43 and 4% had these injuries based on ISS. Twelve months post-injury LOS ≥7 days versus ≤1 day was associated with an estimated 9 units lower mean SF12 PCS using a minimally sufficient adjustment model, and LOS ≥ 7 days was associated with a 3 units lower mean SF12 MCS score. Mediation analyses (LOS ≥ 7 days vs ≤1 day) found for SF12 MCS outcomes, effects of injury severity were small and mostly indirect (direct effect - 0.03, indirect effect - 0.22). Whereas for SF12 PCS outcomes the effect of having a more severe injury rather than mild were both direct and indirect (direct effect - 0.50, indirect effect - 0.38).Conclusions: Individuals with severe injuries (those with LOS ≥ 7 days and ISS 12+) had poorer recovery 12 months after the injury. In addition, post-injury mediators have an important role in influencing long-term health outcomes.Trial Registration: Australia New Zealand Clinical trial registry identification number - ACTRN12613000889752 . [ABSTRACT FROM AUTHOR]

Background: Impaired work ability and reduced life satisfaction due to long-term musculoskeletal pain, particularly in neck, shoulders and back, are considered occupational health problems that can result in workers taking sick leave. The aim of the study was to determine whether work ability and life satisfaction predict return to work (RTW) among women with long-term neck/shoulder and/or back pain, and to assess the ability of the Work Ability Index (WAI) and the Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW). Methods: This is a cohort study with 1-year follow-up. A survey was sent to 600 women receiving sick leave benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and life satisfaction predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and the LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted. Results: Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04–1.22). Life satisfaction was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after 1 year (Area under curve 0.78, 95% CI: 0.70–0.86), but the LiSat-11 did not. Conclusions: This study supports a relationship between work ability and RTW among women on sick leave for long-term neck/shoulder and/or back pain. The results indicate that the WAI, but not the LiSat-11, can discriminate between RTW and NRTW in the population under study. Although the discriminative ability of the WAI needs to be verified in new samples before it can be recommended for use in rehabilitation settings, we suggest that healthcare professionals consider how women perceive their work ability in order to better support them in their RTW. [ABSTRACT FROM AUTHOR]

Background: Long-term sick leave due to common mental disorders (CMDs) is a great burden in society today, especially among women. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour.Methods: The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (> 2 months) due to CMDs were included in the study. The questionnaires for data collection were: "RTW Beliefs Questionnaire", the "General Health Questionnaire -12" and the "EuroQol Visual Analogue Scale". Standard multiple regression analysis was performed both with and without adjustment for potential confounders.Results: The results showed that a more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention.Conclusion: The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs. [ABSTRACT FROM AUTHOR]

Return to work (RTW) has been specifically identified as a high priority in patients undergoing total hip arthroplasty (THA). This investigation sought to assess the effect of the stem design on patients' RTW. Secondly, the study aimed to identify risk factors that lead to a delayed RTW. Questionnaires inquiring about RTW, employment history, educational level, type of work, physical demands and joint awareness were administered by post. Further data were collected from patients' hospital records. 176 patients who underwent THA using a short-stem and 97 patients using a straight-stem design were compared. The median return to work time was 10 weeks [IQR 7–14 weeks], with no significant difference between the two groups (short stems vs. straight stems; 10 [IQR 7–14] vs. 11 [7.5–13.5] weeks; p = 0.693). In the multivariate linear regression analysis, self-employment vs. employee (p = 0.001), dimension of preoperative workload (p = 0.001), preoperative sick leave (p < 0.001), and hospital length of stay (LOS) (p < 0.001) independently affected the period until work was resumed. The Forgotten-Joint-Score-12 showed no significant difference between the two groups. The data show that the majority of THA patients can expect to resume work and stem design has no impact on RTW. Employees with preoperative sick leave, prolonged hospital LOS and low workload are at higher risk for a delayed RTW. [ABSTRACT FROM AUTHOR]

Background: Work participation is an important determinant of public health; being unemployed leads to a decrease in an individual's health. In the Netherlands, people with a work disability can apply for disability benefits, in which people also receive support to return to work (RTW). A method, currently used in the medical sector, that can include both the perspective of the reintegration professional and of the individual in the process of RTW, is shared decision making (SDM). In this article we explore to what extent reintegration professionals currently use SDM, and to what extent they prefer to use SDM in their ideal interaction with clients.Methods: We performed semi-structured interviews with fourteen reintegration professionals from four different municipalities. The transcripts were coded according to content analysis, applying open and axial coding.Results: Reintegration professionals emphasised the importance of having a good relationship with clients, of building trust and collaborating as a team. They did not inform their clients that they could be part of the decision-making process, or discussed a shared goal. Although professionals did emphasise the importance of aligning their approach with the preferences of the client and though they tried to offer some choice options, they did not mention available options, discussed the pros and cons of these options or evaluated decisions with their clients. Furthermore, they did not mention any of these aspects in their ideal interaction with clients.Conclusions: SDM has a potential value, because all professionals underline the importance of having an alliance with clients, collaborating as a team, and striving to align their approach with the preferences of the client. However, professionals currently perform a limited set of SDM steps. Additional knowledge and skills are needed for both reintegration professionals and municipalities so that professionals can consider and reflect on the value of using SDM, or SDM steps, in supporting RTW. Providing clients with knowledge and skills seems necessary to facilitate both self-management and SDM. [ABSTRACT FROM AUTHOR]

Measures to activate sick‐listed workers and to combine work with sickness benefits are a growing but little‐studied policy field. This article investigates graded sick leave benefits in Sweden, Finland and Germany. The analysis reveals some commonalities between countries, as well as substantial differences in terms of institutional background, benefit design and governance. The schemes range from models in which grading has become an integral component of the regular sickness certification process, to models in which the graded‐work option is targeted at a much smaller category of workers and has a stronger therapeutic character. The variation in design and governance of the models is reflected in large differences in terms of their diffusion. All schemes face a common set of obstacles and challenges. They relate in particular to the distribution of stakeholders' roles and responsibilities, the involvement of employers and the assessment of residual work ability. [ABSTRACT FROM AUTHOR]

Background: A 45-year- old Japanese male pharmacist developed a stroke in December 2018; hence, he had left-sided hemiplegia due to the after-effects of cerebral stroke. This paper reports the return-to- work (RTW) and after RTW support for poststroke patients from a combined ergonomic and rehabilitation perspective. Methods: From April 2019 to July 2020, we visited hospitals and workplaces multiple times, making various preparations for workplace accommodation and exchanging information as follows: allowing staggered working hours; securing the flow routes in the back room; equipping a cane holder on his working desk; and adjusting the position of the work tablet. In August 2020, after RTW, we conducted a brief evaluation of residual motor function and an on-site task analysis, and we subsequently made a support tool. Results: In July 2020, his RTW was eventually realized. Moreover, as a result of introducing the tailor-made support tool, the duration of certain tasks that he had been claiming to be difficult was reduced when compared to that before support-tool use, and the average task duration before and after support-tool use was 32.8 s and 10 s, respectively (reduced by approximately 69.5%). Conclusion: To augment our efforts, hospital staff, support staff in his workplace, and his employer collaborated to make various workplace accommodations for the smooth realization of RTW before and after RTW. In the present case, the ergonomic and rehabilitation approach after RTW might have contributed to ease of task, work efficiency, and the potential for future job retention. [ABSTRACT FROM AUTHOR]

Many persons living with HIV (PLWH) either reduced their employment capacity or stopped work completely due to disease progression. With the advent of effective antiretroviral therapy, some PLWH were able to return to the workforce and many are now transitioning into retirement. We examined the histories of employment, retirement and disability status on depression among 1,497 Participants living with HIV from 1997 to 2015 in the Multicenter AIDS Cohort Study. Data were collected on depressive symptoms, employment, retirement, disability status as well as HIV-related and sociodemographic characteristics. Employment, retirement and disability status were lagged 2 years to assess whether the risk of depression at a given observation were temporally predicted by each respective status, adjusting for prior depressive symptoms and covariates. Being employed (aOR: 0.76; 95% CI: 0.71–0.82) had lower odds of depression risk two years later compared to those unemployed. There were higher odds of depression risk associated with disability (aOR: 1.43; 95% CI: 1.32–1.54) versus those not on disability. Retirement status was not associated with the risk of depressive symptoms. These findings could help inform policies and employment programs to facilitate the return to work for PLWH who are willing and able to work. [ABSTRACT FROM AUTHOR]

Purpose: It is not yet known if unicompartmental knee arthroplasty (UKA) patients are more likely to return to work sooner or have improved ability to work (i.e., workability) than total knee arthroplasty (TKA) patients. The following questions were addressed: patients were assessed to determine: (1) whether they returned to work sooner following UKA compared to TKA; (2) whether UKA patients had better WORQ function scores compared to TKA patients; and (3) if UKA patients have higher workability scores and greater satisfaction regarding workability than TKA patients.Methods: A multicenter retrospective cohort study was performed that included patients at least 2 years after having undergone either UKA or TKA surgery and on the condition that patients had been in work in the 2 years prior to surgery. Time period between stopping work and returning to work was assessed; the WORQ scores (0 = worst-100 = best) and the Work Ability Index (WAI = 0-10) and reported satisfaction with work ability.Results: UKA patients (n = 157, median 60 years, 51% male) were compared to TKA patients (n = 167, median 60 years, 49% male) (n.s.). Of the 157 UKA patients, 115 (73%) returned to work within 2 years compared to 121 (72%) of TKA patients (n.s.). More UKA patients return to work within 3 months (73% versus 48%) (p < 0.01). WORQ scores improved similarly in both groups. The WAI was also comparable between the groups. Dissatisfaction with workability was comparable (UKA 15% versus TKA 18% (n.s.).Conclusion: TKA and UKA patients have similar WORQ, WAI, and satisfaction scores. However, in this study population, UKA patients to return to work after surgery significantly sooner than TKA patients, which improves their quality of life and allows them to participate actively in society. This information can help health care providers and patients weigh-up the pros and cons and choose the best treatment and timing for patients in the working population.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]

Background: Long-term sickness absence results in increased risks of permanent disability and a compromised quality of life. Return to work is an important factor in reducing these risks. Little is known about return to work factors for long-term sick-listed workers with subjective health complaints. The aim of this study was to evaluate prognostic factors for partial or full return to a paid job for at least 28 days for long-term sick-listed workers with subjective health complaints, and to compare these factors with those of workers with other disorders.Methods: Data from a prospective cohort study of 213 participants with subjective health complaints and 1.037 reference participants were used. The participants answered a questionnaire after 84 weeks of sickness absence. Return to work was measured after one and two years. Univariable logistic regression analyses were performed (P ≤ 0.157) for variables per domain with return to work (i.e. demographic, socio-economic and work-related, health-related, and self-perceived ability). Subsequently, multivariable logistic regression analyses with backward selection (P ≤ 0.157) were performed. Remaining factors were combined in a multivariable and final model (P ≤ 0.05).Results: Both for workers with subjective health complaints and for the reference group, non-health-related factors remained statistically significant in the final model. This included receiving a partial or complete work disability benefit (partial: OR 0.62, 95% CI 0.26-1.47 and OR 0.69, 95% CI 0.43-1.12; complete: OR 0.24, 95% CI 0.10-0.58 and OR 0.12, 95% CI 0.07-0.20) and having a positive self-perceived possibility for return to work (OR 1.06, 95% CI 1.01-1.11 and OR 1.08, 95% CI 1.05-1.11).Conclusions: Non-health-related factors seem to be more important than health-related factors in predicting return to work after long-term sickness absence. Receiving a work disability benefit and having negative expectations for return to work seem to complicate return to work most for workers with subjective health complaints. With respect to return to work predictors, workers with subjective health complaints do not differ from the reference group. [ABSTRACT FROM AUTHOR]

Objective. To examine to what extent disabling osteoarthritis (OA), leading to a prolonged sickness absence (SA), interferes with work participation and shortens working life--years. Methods. A total of 4704 wage earners aged 30 to 59 years, whose SA due to OA started in 2006, were followed until October 31, 2014. Kaplan--Meier analysis was used to plot sustained (at least 28 consecutive days) return-to-work curves. The associations of potential determinants with early exit from paid employment were examined applying Cox proportional hazards regression analysis. Years expected to be spent in different work participation statuses until statutory retirement age were estimated based on daily work participation statuses using adapted Sullivan method. Results. Persons with knee OA showed the fastest, and persons with hip OA the slowest, sustained return to work. Although most participants typically were at work during the first year of followup, a considerable proportion was permanently retired. Male sex, older age, low education, long initial SA, and having not returned to work sustainably, as well as receiving vocational rehabilitation, predicted early exit from paid employment during the followup. Overall, only 45-53% of potential working life--years were estimated to be spent at work, being highest for the oldest age group. Conclusion. Our study showed a considerable effect of OA on work participation and working life duration. Clinicians should avoid prescription of long SA or temporary work disability due to OA without a clear treatment or return-to-work plan. [ABSTRACT FROM AUTHOR]

Background: When returning to work after being on long-term sick leave, individuals may experience varying levels of motivation and self-efficacy. Motivational interviewing (MI) is a counseling style that aims to increase motivation towards change, and it may be useful in the return to work (RTW) process. The aim of this study was to explore sick-listed workers' experiences with MI in the RTW process.Methods: This qualitative study was part of a randomized controlled trial evaluating the effects of MI on the RTW process, and it was administered by caseworkers at the Norwegian Labor and Welfare Administration. Sixteen sick-listed individuals, aged 33-60, participated in semi-structured interviews. All had a sick leave status of 50-100% for at least 8 weeks when interviewed and all had completed 2 MI sessions. The data was analyzed with systematic text condensation.Results: Participants' experiences of the MI sessions were categorized into three themes: (1) relationship with the MI caseworker, (2) normalizing sick leave, and (3) adjusting RTW strategies. The MI sessions were experienced as a positive encounter due to the supportive relationship that was built between the MI caseworker and the sick-listed worker. Being sick listed led to feelings of guilt and stigmatization, but acceptance and support from the MI caseworkers helped normalize the situation for the sick-listed workers. Furthermore, MI sessions allowed for personalized feedback and discussions on adjustments to their RTW strategies.Conclusion: Sick-listed workers experienced MI as positive due to the good relationship that developed with the MI caseworker, how this normalized sick leave, and the help they received with adjusting their RTW strategies. Professionals working with individuals attempting to RTW may benefit from using MI as a method for helping sick-listed workers to RTW.Trial Registration: ClinicalTrials.gov: NCT03212118 (registered July 11, 2017). [ABSTRACT FROM AUTHOR]

Background: Mental disorders are the most common reason for sick leave in Sweden. Knowledge about effective methods to help these individuals to return to work (RTW)/entry into work or studies is limited. Rehabilitation coordinators (RC's) have been introduced within healthcare with the purpose to promote cooperation, streamline the sick leave and rehabilitation process, and facilitate RTW for sick-listed patients. The function of RC's has shown positive results by reducing sick leave within primary healthcare. However, the function has not been evaluated in terms of specialist psychiatry. This paper describes the design of a study to evaluate effects of a RC intervention on sick leave and RTW/entry in work or studies in patients with moderate to severe affective and/or moderate to severe anxiety disorders within specialist psychiatric care.Methods: A randomised controlled trial (RCT) comparing an intervention group receiving support from a RC with a control group receiving treatment as usual (TAU). The target group is patients on sick leave, treated for affective and/or anxiety disorder, aged 25-64, with or without employment.Discussion: This study gives the possibility to evaluate a RC intervention for individuals with mental disorders. If the study has promising vocational outcomes, it may be of importance for the participants in many ways, e.g. increase participation in society, provide economic benefits and improve health and wellbeing. This would be valuable for the individual as well as for the society.Trial Registration: The study is registered at the Clinicaltrials.gov Register Platform (ID NCT03729050) in 2 November 2018. [ABSTRACT FROM AUTHOR]

Background: For people with disabilities, chances to find or keep work are negatively affected by multiple problems like lower education, poverty and poor health. Furthermore, although active labour market policies proved to be effective for unemployed in general, success rates are poor for persons who are unemployed due to multiple problems. The present study aims to describe the development of a method as well as professional training to teach its application, and to assess the feasibility of method and training. The Strength-based method (CARm) aims to promote employment of work-disability benefit recipients with multiple problems.Methods: The main principles of the Strength model were redesigned for better applicability in a population of work-disability beneficiaries, resulting in the CARm method. As part of the CARm method, a training module for Labour Experts (LEs) was developed. To assess the new designed method and training, a one-group, pre-post design was used. Data were collected from eight participating LEs, five female and 3 male, aged between 41and 55 years and having 2-17 years working experience. We used self-report questionnaires and a semi-structured discussion meeting after the training sessions with the LEs.Results: Eight labour experts (LEs) from the Dutch Social Security Institute participated in the study. Most LEs felt an improvement in their ability to ascertain developmental needs, opportunities and threats in the client's situation. Three months after the training, LEs almost unanimously agreed on the statements 'I expect to use the CARm method more frequently in the future' and 'I use the CARm method in daily practice whenever possible'. The overall rating for the training on a scale from 1 to 10 was 7.6 (range 7-9). The overall satisfaction with the trainers was good.Conclusions: The CARm method and training was found to be a feasible approach to facilitate LEs working at the UWV reintegration service to support clients with multiple problems. Sufficient managerial support for participating LEs is a key factor for successful implementation of CARm. Results show that CARm is worth testing for efficacy in a future trial. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify predictors of returning to work in a group of cancer patients that sought and received help from mental health care institutes specialized in psycho-oncological therapy. Moreover we identified which psychosocial factors were seen as important for returning to work by these patients and therapists working at these institutes. Method: This naturalistic study focused on cancer patients who applied for help at specialized psycho-oncology institutions in the Netherlands. Data were collected before the start of psychological care (T1), and three (T2) and nine (T3) months thereafter. Predictors of return to work were identified based on the opinion of therapists and patients from psycho-oncology institutions in the Netherlands. Predictor scores at T1 were used to predict return to work at T3. Discrimination between patients with and without return to work at T3 was investigated with receiver operating characteristic (ROC) analysis and expressed as the area under the ROC curve (AUC). Results: At T1, 174 participants (79%) were off work due to sickness and 119 (68%) had returned to work at T3. Therapists and patients identified psychological symptoms, quality of life, comorbidity, helplessness, acceptation, mastery, stressful life-events, well-being, and domestic and social functioning as being important for predicting return to work. Domestic functioning was the strongest predictor of return to work at T3. The prediction model including all identified predictor variables did not discriminate between patients with and without return to work at T3, with AUC = 0.652 (95% CI 0.553-0.751). Conclusions: These results suggest that, although psychological symptoms are important at face validity for return to work after cancer, in patients that received help for psychological symptoms, they do not predict return to work. [ABSTRACT FROM AUTHOR]