Journal Of Occupational Rehabilitation[JOURNAL]
Sun
200 papers
Return to Work After Lower Limb Amputation: A Critical Challenge in Jordan's Socioeconomic and Healthcare Context.
Al Qaroot B, Sobuh M, Al-Imyan F … +3 more , Al-Laham E, Hawamdeh Z, Khanfar A
J Occup Rehabil · 2026 Apr · PMID 41964769 · Publisher ↗
BACKGROUND: After lower limb amputation (LLA), return to work (RTW) is an essential step, signifying the economic stability of people with amputation, psychological recovery, and social reintegration. While RTW is well-s...
BACKGROUND: After lower limb amputation (LLA), return to work (RTW) is an essential step, signifying the economic stability of people with amputation, psychological recovery, and social reintegration. While RTW is well-studied in high-income countries, the experiences of people with amputation in low- and middle-income countries like Jordan remain poorly characterized within contexts of prominent systemic barriers. OBJECTIVE: This study aimed to quantify the RTW rate after LLA in Jordan and identify the facilitators and barriers to vocational reintegration. METHODS: In a cross-sectional study, 119 male participants with amputation of working age participated in structured face-to-face interviews. Data collected included demographic and clinical variables (e.g., amputation level), clinical-outcome measures (socket comfort score, SIGAM mobility scale, London Handicap Scale), and employability, which was assessed using a validated employment questionnaire (EQ) to quantify work status and identify barriers to employment. RESULTS: The RTW rate was 34.5%. Employed individuals reported significantly greater mobility, socket comfort, and lower perceived handicap. For all participants, higher education and better functional outcomes predicted greater employability. A critical divergence emerged in that for employed people with amputation, clinical factors like socket comfort were significantly associated with their work experience (p = 0.03), whereas for unemployed participants, these factors showed no association. CONCLUSION: The low RTW rate (34.4%) highlights an urgent need for systemic change. The finding suggests that for most people with amputation, RTW may be impeded not by their medical condition alone, but by external barriers likely including inaccessible workplaces and the absence of vocational rehabilitation. To unlock the potential of people with amputation, rehabilitation must evolve into a comprehensive socio-medical system that integrates vocational training, advanced prosthetic care, and equitable policies.
Societal and Economic Impact of Informal Caregiving for Musculoskeletal Conditions: A Productivity-Adjusted Life Year (PALY) Study.
Alemu NL, Das N, Watts JJ … +3 more , Robinson S, Chen G, Gao L
J Occup Rehabil · 2026 Apr · PMID 41961422 · Publisher ↗
BACKGROUND: Musculoskeletal conditions (MSCs) are a leading cause of disability and chronic pain globally, yet the long-term economic impact on informal caregivers remains underexplored. The productivity-adjusted life ye...
BACKGROUND: Musculoskeletal conditions (MSCs) are a leading cause of disability and chronic pain globally, yet the long-term economic impact on informal caregivers remains underexplored. The productivity-adjusted life year (PALY) framework offers a novel method for estimating lifetime productivity losses associated with caregiving, providing a broader societal perspective than conventional short-term productivity metrics. OBJECTIVE: To quantify long-term productivity and health-related quality of life among informal caregivers of individuals with MSCs in Australia, using PALYs and quality-adjusted life years (QALYs) over 30 years. METHODS: A dynamic life-table model was developed to simulate two cohorts-informal caregivers of people with MSCs and a matched non-caregiver control group-across a 30-year time horizon (2024-2053). The model incorporated Australian age- and sex-specific data on caregiver prevalence, mortality, labour force participation, absenteeism, and presenteeism. PALYs were calculated by combining full-time equivalent (FTE) labour force participation with productivity indices. QALYs were estimated using health utility values adjusted for caregiver-specific disutility. Productivity losses were monetized using GDP per FTE worker. Deterministic and probabilistic sensitivity analyses were conducted to assess model robustness. RESULTS: Informal caregiving for MSCs resulted in an estimated loss of 896,523 PALYs and 487,950 QALYs, with an associated productivity cost of AUD $203.3 billion over 30 years ($44,808 per carer). On an annual basis, this equates to 29,884 PALYs and AUD $6.78 billion in lost productivity. Female carers bore a disproportionate share of the burden, accounting for 53% of PALYs lost and 59% of QALYs lost. The probabilistic sensitivity analysis indicated the base-case was likely conservative, estimating mean productivity losses of AUD $252.1 billion, with a 95% CI ranging from AUD $249.5 billion to $254.6 billion, reflecting parameter uncertainty within model assumptions. CONCLUSIONS: This study provides the first application of the PALY framework to informal caregivers of MSCs in Australia and globally. Informal caregiving for MSCs imposes a substantial and under recognized economic burden. Applying the PALY framework provides compelling evidence for incorporating caregiver productivity into economic evaluations and policy decisions aimed at supporting the informal care workforce. Findings highlight the need for targeted workplace and policy measures, particularly to address the disproportionate impact on women.
Authorization to Disclose: How Occupational Physicians Interpret Confidentiality in Return-to-Work Negotiations.
Keränen H, Pesonen S, Tiitinen S … +3 more , Weiste E, Juvonen-Posti P, Ala-Mursula L
J Occup Rehabil · 2026 Apr · PMID 41954700 · Publisher ↗
PURPOSE: To analyze occupational physicians' (OPs) interpretations of confidentiality regarding health information in multistakeholder return-to-work (RTW) negotiations, situated at the intersection of healthcare and wor...
PURPOSE: To analyze occupational physicians' (OPs) interpretations of confidentiality regarding health information in multistakeholder return-to-work (RTW) negotiations, situated at the intersection of healthcare and working life. MATERIAL AND METHODS: Reflexive thematic analysis was applied to 14 video-recorded RTW negotiations and 14 interviews with OPs involved in these negotiations. RESULTS: Four themes were developed, showing how OPs navigate confidentiality by (i) addressing knowledge asymmetries among participants, (ii) balancing their dual role in fostering trust, (iii) constructing confidentiality as depending on employees' willingness to disclose health information, and (iv) approaching confidentiality flexibly to find solutions for RTW. Interpretations varied across and within negotiations, depending on specific situations or negotiation objectives. CONCLUSION: Our study reveals that OPs' aim at restricting discussions on employees' health and respect their autonomy in disclosing health information in RTW negotiations, yet their approach to confidentiality seems complex and situationally flexible. Confidentiality issues compete with other incentives and complicate the collaboration, thus careful attention, ethical considerations, and clearer guidance from policymakers are required. The demanding nature of planning and leading RTW negotiations calls for systematic education of interaction skills in OPs' specialist training. Further research is needed to explore the strategies and meaning-making related to confidentiality in multistakeholder RTW collaboration.
Effects of Reducing the Number of Quick Returns (< 11 h off Between Shifts) on Turnover Intention and Job Satisfaction: a Cluster-Randomized Controlled Trial Among Healthcare Workers.
Sunde E, Djupedal ILR, Vedaa Ø … +7 more , Pallesen S, Bjorvatn B, Waage S, Nielsen MB, Lie SA, Kysnes BB, Harris A
J Occup Rehabil · 2026 Apr · PMID 41933114 · Publisher ↗
PURPOSE: To investigate the effects of reducing quick returns (i.e., < 11 h between shifts) on turnover intention and job satisfaction, and to explore potential moderating factors. METHODS: A cluster-randomized controlle...
PURPOSE: To investigate the effects of reducing quick returns (i.e., < 11 h between shifts) on turnover intention and job satisfaction, and to explore potential moderating factors. METHODS: A cluster-randomized controlled trial was conducted at a Norwegian university hospital, where 66 units were randomly assigned to an intervention or control group. Participants, comprising healthcare workers (n = 1314; 85.2% female) contracted to ≥ 50% of full-time positions, were followed over six months. The intervention group was assigned to a work schedule with fewer quick returns, while the control group maintained its level of quick returns. Turnover intention and job satisfaction were assessed at baseline and follow-up using validated self-report measures. Linear mixed models were used to evaluate intervention effects and potential moderators. RESULTS: The intervention group halved the number of quick returns from baseline (mean = 13.2, SD = 8.7) to follow-up (mean = 6.7, SD = 6.0), while the control group showed minimal change (baseline mean = 13.2, SD = 8.7; follow-up mean = 12.0, SD = 9.3). No overall effects were found on turnover intention and job satisfaction. However, moderator analyses revealed that among workers aged 30-41 years, the intervention reduced turnover intention (p = .003, Cohen's d = -0.54), primarily observed among workers aged 30-41 years with no children at home, and improved job satisfaction (p = .003, Cohen's d = 0.54). Additionally, beneficial effects on turnover intention were found among workers with commuting times exceeding 45 min. CONCLUSIONS: Reducing quick returns improved job satisfaction and reduced turnover intention in specific subgroups. These findings highlight the importance of considering factors such as age, family status, and commuting time, when planning shift schedules in healthcare settings. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04693182 (registered 12/31/2020).
Effectiveness of mHealth Interventions on Physical Activity and Sedentary Behavior Among Office Workers: A Systematic Review and Meta-analysis.
Chandrasekaran B, Rao CR, Thirunavukkarasu E … +3 more , Jadhav R, Srivastav P, Bairapareddy KC
J Occup Rehabil · 2026 Mar · PMID 41917517 · Publisher ↗
PURPOSE: Insufficient physical activity (PA) and prolonged sedentary time (ST) are well-established risk factors for chronic diseases. This systematic review and meta-analysis aimed to determine the effectiveness of mobi...
PURPOSE: Insufficient physical activity (PA) and prolonged sedentary time (ST) are well-established risk factors for chronic diseases. This systematic review and meta-analysis aimed to determine the effectiveness of mobile health (mHealth) interventions in reducing ST and improving PA specifically among desk-based office workers. METHODS: A systematic search was conducted across six electronic databases to identify empirical studies published up to June 2025 that evaluated workplace ST/PA interventions delivered via mobile devices among office workers. Eligible studies included office workers aged > 18 years and employed mHealth interventions. Primary outcomes were self-reported or objectively measured PA and ST. RESULTS: Thirty-eight studies met inclusion criteria, encompassing 74,251 participants (mean age: 40.02 ± 6.71 years; 41% male). mHealth interventions significantly reduced ST levels: overall ST (standardized mean difference [SMD] = - 1.58; 95% CI - 2.34 to - 0.83; p < 0.0001; low certainty), prolonged ST (SMD = - 1.16; 95% CI - 1.98 to - 0.34; p = 0.006; very low certainty), and improved daily step count (SMD = 3.84; 95% CI 2.66 to 5.03; p < 0.00001; very low certainty). Substantial heterogeneity, low-powered studies, and high risk of bias contributed to low-to-moderate evidence quality. CONCLUSIONS: The evidence suggests that mHealth interventions may produce small to moderate increase in PA and reductions in ST among sedentary workers; however, the overall effects remain uncertain due to heterogeneity in outcome measurements, gaps in follow-up assessments, and limited sample sizes. Further high-quality, long-term studies are warranted to evaluate the sustained benefits of mHealth interventions across traditional and hybrid office settings. TRIAL REGISTRATION: Prospectively registered at PROSPERO (CRD42025635312).
Employment Experiences of People Living with Young-Onset Dementia: Perspectives from Workers, Care Partners, and Employment Specialists in Taiwan.
Wang ZL, Zaslavsky O, Huang SL
J Occup Rehabil · 2026 Mar · PMID 41910897 · Publisher ↗
PURPOSE: Young-onset dementia (YOD), diagnosed before age 65, presents unique challenges for individuals in their working years. While most research on YOD and employment has been conducted in Europe, little is known abo...
PURPOSE: Young-onset dementia (YOD), diagnosed before age 65, presents unique challenges for individuals in their working years. While most research on YOD and employment has been conducted in Europe, little is known about experiences in Taiwan, where disability legislation provides general protections but lacks dementia-specific workplace policies. This study explored how people living with YOD adapt in the workplace, how care partners perceive and support their relatives' employment, and how Employment Specialists view current practices and opportunities to strengthen workplace support. METHODS: The study conducted a qualitative study using semi-structured interviews with 14 participants: five individuals living with YOD, six family care partners, and three Employment Specialists. Recruitment occurred in northern Taiwan through clinics, support groups, and professional networks. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis, integrating perspectives across stakeholder groups. RESULTS: We identified three themes: (1) People living with YOD adapt to workplace challenges through workload changes, organizational tools, and daily routines; (2) Gaps in awareness and policy limit support for both employees living with YOD and their care partners; and (3) Tailored, strength-based career support empowers people living with YOD to stay engaged in meaningful work. CONCLUSION: Findings highlight both individual resilience and systemic gaps in Taiwan. Strength-based, tailored career supports, alongside policy reforms and expanded resources for care partners, are essential for sustaining employment. Insights from Taiwan contribute to the international literature by illustrating how cultural and policy contexts shape workplace inclusion for people living with YOD.
Return to Work Following Osteochondral Allograft Transplantation in the Knee.
Rucinski K, Crecelius CR, Nuelle CW … +2 more , Stannard JP, Cook JL
J Occup Rehabil · 2026 Mar · PMID 41863744 · Publisher ↗
PURPOSE: This study evaluates return-to-work (RTW) timing and level in a large cohort of knee osteochondral allograft transplant (OCAT) patients in order to characterize RTW variables associated with successful outcomes...
PURPOSE: This study evaluates return-to-work (RTW) timing and level in a large cohort of knee osteochondral allograft transplant (OCAT) patients in order to characterize RTW variables associated with successful outcomes and clarify expectations stratified by occupational category. METHODS: A prospective joint preservation registry was used to analyze RTW following primary knee OCAT. Patient demographic, surgical, and RTW timing variables were extracted from the medical record. The United States Bureau of Labor Statistics Standard Occupational Classification system was used to classify patients into 23 major occupational groups and to classify physical level of work (low, moderate, high). RESULTS: 161 employed patients and 35 students were analyzed; 156 patients (96.9%) returned to work, and all students (100%) returned to school. No demographic or surgical factors analyzed were significantly associated with RTW failure. A mean return to light duty occurred at 57 days (range: 2-373 days), and mean return to full duty at 211 days (range: 17-1,073 days) after OCAT. Patients in high demand jobs were significantly (p = .002) more likely to report a delayed return (> 55 days to return) to light duty. High demand jobs (p < .01) and male sex (p = .003) were significantly associated with a delayed return (> 216 days) to full duty. CONCLUSION: RTW was achieved by 97% of patients after OCAT, with timing of RTW strongly influenced by occupational physical demands. This study provides clinicians and patients with practical guidance to support shared decision-making and pre-operative planning.
Return to Work After Isolated Spinal Injury: Rates, Predictors, and Implications for Occupational Reintegration.
Raisch P, Hirth T, Kreinest M … +3 more , Vetter SY, Grützner PA, Jung von Landenberg MK
J Occup Rehabil · 2026 Mar · PMID 41862770 · Publisher ↗
PURPOSE: Spinal injuries are an increasing cause of disability and work absence. While return to work (RTW) is a key outcome, most studies included heterogeneous cohorts with concomitant injuries or spinal cord involveme...
PURPOSE: Spinal injuries are an increasing cause of disability and work absence. While return to work (RTW) is a key outcome, most studies included heterogeneous cohorts with concomitant injuries or spinal cord involvement. This study examined RTW after isolated spinal injury, and identified demographic, clinical, occupational, and socioeconomic predictors of early RTW. METHODS: We conducted a retrospective single-center cohort study of patients ≤ 60 years treated for isolated traumatic spinal fractures or discoligamentous injuries (2016-2020). Patients with spinal cord injury, major concomitant trauma, or pathological fractures were excluded. Structured telephone interviews assessed posttreatment, rehabilitation, and occupational outcomes. Early RTW was defined as resumption of employment within six months. Predictors were evaluated using univariate analyses and multivariable logistic regression after least absolute shrinkage and selection operator (LASSO) selection. RESULTS: In total, 86 patients participated. At 12 months, 71% had returned to work; however, 50% reported workplace limitations and 37% had not regained pre-injury performance. RTW rates varied by treatment and spinal region. In multivariable analysis, surgical treatment (OR 0.13, 95% CI 0.03-0.42), female sex (OR 0.25, 95% CI 0.08-0.72), and working > 30 h/week pre-injury (OR 0.09, 95% CI 0.01-0.66) predicted lower odds of early RTW. Self-employment was positively associated with early RTW in univariate analysis. CONCLUSIONS: Sociocultural, occupational, and medical factors, including female sex, high pre-injury workload, and surgical treatment, significantly influenced RTW outcomes. Future studies should explore tailored rehabilitation and workplace interventions to support at-risk groups and improve long-term reintegration.
Informing a Workplace Self-Management Intervention for Employees with Long-Term Health Conditions and Disabilities: A Mixed-Methods Study.
Clarkson K, Maidment DW, Yarker J … +1 more , Munir F
J Occup Rehabil · 2026 Mar · PMID 41860691 · Publisher ↗
PURPOSE: No practical, scalable framework currently exists for UK workplaces to support self-management of LTCs/disabilities in collaboration with employers and health systems. This study aimed to understand the essentia...
PURPOSE: No practical, scalable framework currently exists for UK workplaces to support self-management of LTCs/disabilities in collaboration with employers and health systems. This study aimed to understand the essential components of a workplace-based intervention to support self-management for individuals with long-term health conditions and disabilities to inform the development of a new intervention to support self-management. METHODS: A multi-step, mixed methods approach was used. Obstacles and facilitators to workplace self-management were identified from prior research were translated into guided activities for multi-stakeholder workshops (workers, managers, employer stakeholders, ICS, professional bodies, charities, and trade unions). The participants discussed each obstacle/facilitator in groups either online or in-person workshops. Workshop findings informed a three-round electronic Delphi study was conducted. Reflexive inductive thematic analysis was conducted for the workshop findings and SPSS was utilised for the Delphi findings. RESULTS: Twelve obstacles and facilitators were identified and discussed in the workshops. Three themes were generated for the support needs of the workers, two for managers, and three for employer stakeholders from the workshops. At the end of the Delphi, 13 out of 14 statements reached consensus for intervention delivery, and 54 out of 59 statements reached consensus for intervention content. CONCLUSION: Consensus supported the development of a co-designed, flexible and multi-format intervention tailored to workers with a long-term health condition or disability, managers and employer stakeholders. Active engagement with diverse organisational stakeholders is likely to improve uptake and consistency.
Associations Between Social Insurance Literacy and Perceived Justice and Perceived Fairness in a Work Disability Claim Setting.
Vervenne D, Brouwer S, Ziech M … +5 more , Coffeng J, Krause B, Engel O, de Vries H, Abma F
J Occup Rehabil · 2026 Mar · PMID 41843230 · Publisher ↗
PURPOSE: Successful completion of processes within the social insurance system depends on both individual characteristics of work disability applicants and structural characteristics of the system itself. The interaction...
PURPOSE: Successful completion of processes within the social insurance system depends on both individual characteristics of work disability applicants and structural characteristics of the system itself. The interaction between individuals' knowledge and abilities and the comprehensibility of the system constitutes what is referred to as social insurance literacy (SIL). Limited SIL may lead to feelings of injustice or unfairness. The aim of this study was to examine the associations between SIL and perceived justice and fairness among clients applying for work disability benefits. METHODS: A cross-sectional survey study was conducted among clients applying for work disability benefits within the Dutch social insurance system. Data were collected on the four domains of SIL (individuals' ability to obtain; to understand; to act; and system comprehensibility), and on perceived justice and perceived fairness. Associations were analyzed using multivariable linear regression. RESULTS: A total of 168 respondents were included in the sample. Of the four SIL domains, clients' self-reported ability to act on information was significantly associated with perceived justice [B = 0.26, SE = 0.12]. In addition, system comprehensibility was significantly associated with both fairness [B = 0.57, SE = 0.08] and justice [B = 0.72, SE = 0.09]. No significant associations were found for the domains related to the ability to obtain or understand information. CONCLUSION: System comprehensibility was more strongly associated with perceived justice and fairness than clients' individual abilities to obtain, understand, or act on information. Improving the clarity and accessibility of information provided by the system may be an effective strategy to enhance clients' perceptions of justice and fairness when applying for work disability benefits.
Work Participation Following Vocational Rehabilitation in Occupational Disease Patients: A Propensity Score-Matched Analysis Using Finnish Nationwide Registry Data.
Ojanen V, Korhonen M, Koskela K … +2 more , Reho T, Sauni R
J Occup Rehabil · 2026 Mar · PMID 41826743 · Publisher ↗
PURPOSE: Occupational diseases (ODs) often disrupt careers and threaten long-term employment. Vocational rehabilitation (VR) is intended to restore work ability, yet evidence on its effectiveness for OD patients is scarc...
PURPOSE: Occupational diseases (ODs) often disrupt careers and threaten long-term employment. Vocational rehabilitation (VR) is intended to restore work ability, yet evidence on its effectiveness for OD patients is scarce. This study uses nationwide registry data to evaluate the impact of VR on sustained work participation. METHODS: We analyzed linked data from multiple Finnish registers, including all individuals aged 18-55 who received VR through workers' compensation insurance for an OD recognized between 2005 and 2018. Rehabilitees were propensity score-matched to OD patients without VR. Subgroup analyses distinguished rehabilitees who received formal education during VR from those who did not. Follow-up time averaged 5.1 years and extended up to 8 years post-VR. RESULTS: A total of 1377 matched pairs were formed. Work participation at one year post-VR was lower among rehabilitees than controls (74.1% vs 84.0%), reflecting severe baseline impairment. However, the gap narrowed over time, with near parity at four years (79.1% vs 81.6%). Neither group regained pre-OD levels (> 90%). Recovery was faster among those receiving education: Parity was achieved within two years (82.0% vs 82.7%), and the employment rate continued to improve throughout the 8-year follow-up (84.8% vs 84.4%). CONCLUSIONS: As required by legislation, VR is implemented when other interventions are insufficient to ensure sustainable employability. The results show that VR recipients achieved a level of work participation comparable to that of the control group, although the two groups were not fully comparable due to statutory entitlement. This study suggests that VR effectively promotes labor market integration.
Long COVID and the Challenge of Long-Term Employment: An Ecological, Sequential Explanatory Mixed-Methods Approach.
Su H, Keller B, Danesh V … +6 more , McPeake J, Boehm LM, Eaton TL, Mart MF, Patel MB, Ely EW
J Occup Rehabil · 2026 Mar · PMID 41820731 · Publisher ↗
PURPOSE: To identify and contextualize the determinants of long-term employment, health, and financial outcomes among individuals affected by Long COVID. METHODS: Sequential explanatory mixed-methods study design guided...
PURPOSE: To identify and contextualize the determinants of long-term employment, health, and financial outcomes among individuals affected by Long COVID. METHODS: Sequential explanatory mixed-methods study design guided by the social-ecological model. Adults with Long COVID who were employed before infection and returned to work during the three-year follow-up were recruited through in-person and virtual outpatient venues: ResearchMatch, a Long COVID clinic, and a peer support group affiliated with a medical center. Participants completed validated surveys assessing factors influencing sustained employment. Stratified semi-structured interviews were then conducted to explore how these factors shaped sustained employment. Quantitative data were analyzed using descriptive and inferential statistical methods, while qualitative data were analyzed through content analysis. RESULTS: Among 79 participants who returned to work, 58% (n = 46) remained employed after a mean follow-up of 1,077 days. Those still employed reported reduced capacity and persistent uncertainty. Those no longer employed experienced worse physical health (p < 0.002), greater comorbidity burden (p = 0.01), more environmental barriers (p = 0.02), and increased financial hardship (p = 0.03). Qualitative analyses identified nonlinear return-to-work trajectories shaped by fluctuating and often invisible symptoms, alongside multilevel themes influencing employment sustainability, including misalignment between functional capacity and job demands, challenges obtaining workplace accommodations, stigma, limited policies, and labor market barriers. CONCLUSIONS: Employment sustainability among individuals with Long COVID is shaped by complex, multilevel barriers, with job loss further worsening health and financial hardship. Investment in comprehensive Long COVID care, including multidisciplinary clinical services, vocational rehabilitation, clinician education, public awareness initiatives, employer training, and policy reform, is critical to support long-term recovery and employment sustainability.
Psychometric Evaluation of an ICF-Based Instrument to Assess Work Ability in Occupational Health Care.
Kreuger DCC, Donker-Cools BHPM, Oomens SPCJ … +3 more , Anema JR, Suijkerbuijk YB, Schaafsma FG
J Occup Rehabil · 2026 Feb · PMID 41723760 · Publisher ↗
PURPOSE: Occupational health professionals (OHPs) collaborate to support return to work (RTW) for employees on long-term sick leave, but differences in roles and perspectives can result in inconsistent work ability asses...
PURPOSE: Occupational health professionals (OHPs) collaborate to support return to work (RTW) for employees on long-term sick leave, but differences in roles and perspectives can result in inconsistent work ability assessments. To promote a shared understanding of work ability, the ICF (International Classification of Functioning, Disability, and Health)-based Work Ability & Reintegration Description (WARD) instrument was developed. This study evaluated its psychometric properties, in particular criterion validity and reliability. METHODS: A mixed-methods study was conducted in three phases. Firstly, a reference standard set for assessing work ability in 10 case vignettes was established employing the Modified Delphi method with nine OHPs. Secondly, 22 OHPs independently assessed work ability with the WARD-instrument, for which overall agreement with the reference standard, and inter-rater reliability were calculated. Thirdly, a focus group with eight OHPs explored sources of variation for assessing work ability with WARD. RESULTS: Agreement with the reference standard ranged from 58.6% to 99.5%. High agreement (> 70%) was found for 23 out of 29 items. Specificity (59.7%-99.5%) generally exceeded sensitivity (18.2%-95.5%), indicating greater consistency in ruling out non-relevant items than in identifying relevant ones. Focus group discussions emphasized that assessments should be context-dependent to support rehabilitation purposes. CONCLUSION: The WARD-instrument shows promising criterion validity and reliability, especially for objectifiable and physical aspects of functioning. More complex and context-dependent domains, such as cognitive aspects of functioning and personal factors, remain challenging to consistently assess among different OHPs. Its focus on identifying context-sensitive RTW barriers may support more person-centered sick leave guidance. Further research in real-life practice is needed to strengthen validation and guide implementation.
Exploring the Applicability and Relevance of the Seven Principles for Successful Return to Work in Practice: A Qualitative Analysis of the Perspectives of Disability Managers, Case Managers, and Return-to-work Consultants.
Killip SC, MacDermid JC, Ziebart C … +2 more , Gewurtz RE, Sinden KE
J Occup Rehabil · 2026 Feb · PMID 41721960 · Publisher ↗
INTRODUCTION: The Seven Principles for Successful Return to Work can be used to guide the return-to-work process. QueryThe purpose of this study was to understand the relevance of these principles and their key concepts...
INTRODUCTION: The Seven Principles for Successful Return to Work can be used to guide the return-to-work process. QueryThe purpose of this study was to understand the relevance of these principles and their key concepts to return-to-work practices, and how they are being applied in practice to guide return-to-work from the perspectives of disability managers, case managers and return-to-work consultants. METHODS: We recruited Canadian disability managers, case managers and return-to-work consultants from workplaces, workers' compensation boards and third-party disability management companies. Twelve participants participated in virtual semi-structured interviews about the Seven Principles for Successful Return to Work and their associated concepts (i.e., modified work). We used interpretive description to analyze the transcripts, and two coders performed the thematic analysis. RESULTS: Participants explained how each principle was applied in practice, and the relevance of the principles in their work, identifying that 5 of 7 principles were relevant to their specific field of practice. We identified 5 themes that identified how the concepts within the principles supported return-to-work processes: Communication is critical; The disability manager should be responsible for coordinating return-to-work with the collaboration of stakeholders; Objective and accurate medical information is required in a timely manner; Modified work must be meaningful, productive, and safe; Workplace culture impacts return-to-work. CONCLUSION: Although most principles were relevant, we identified two less relevant principles in some disability management contexts due to the constraints of their work (return-to-work that does not disadvantage other workers; communication between the workplace and the healthcare provider). The principles represent key concepts which can support return-to-work planning for disability management professionals.
The Longitudinal Relationship Between Self-Efficacy and Job Satisfaction Among Workers with Disabilities in South Korea: An Autoregressive Cross-Lagged Panel Analysis.
Yang Y, Kwak Y, Cho S
J Occup Rehabil · 2026 Feb · PMID 41712126 · Publisher ↗
PURPOSE: This study investigated the longitudinal relationship between perceived self-efficacy and job satisfac-tion among employees with disabilities in South Korea using an autoregressive crosslagged model (ACLM). MET...
PURPOSE: This study investigated the longitudinal relationship between perceived self-efficacy and job satisfac-tion among employees with disabilities in South Korea using an autoregressive crosslagged model (ACLM). METHODS: Data were drawn from the 5th (2020) to 7th (2022) years of the 2nd Wave of the Panel Survey of Employment for the Disabled (PSED), collected by the Employment Development Institute of the Korea Employment Agency for the Disabled. A total of 2,024 individuals were included in the final analysis. RESULTS: The key findings are as follows: First, both self-efficacy and job satisfaction exhibited significant auto-regressive effects across time points, indicating that these variables remained stable over time. Second, significant cross-lagged effects were observed between self-efficacy and job satisfaction, confirming a reciprocal, bidirectional relationship in which both variables influence each other over time. CONCLUSION: These findings highlight the necessity of developing practical strategies and bidirectional interventions aimed at enhancing both self-efficacy and job satisfaction among employees with disabilities in South Korea.
Effects of a Work-Related Health Check (Check-Up 45+) on Utilization of Preventive and Rehabilitative Services - Results from a Randomized Controlled Trial.
Telenga S, Hambrecht A, Wiedemann R … +2 more , Haberstroh S, Bitzer EM
J Occup Rehabil · 2026 Feb · PMID 41670797 · Publisher ↗
BACKGROUND: To strengthen prevention and rehabilitation in the workforce, the German Pension Insurance (GPI) is mandated to offer a work-related health examination for individuals aged 45 and over (check-up 45+) within a...
BACKGROUND: To strengthen prevention and rehabilitation in the workforce, the German Pension Insurance (GPI) is mandated to offer a work-related health examination for individuals aged 45 and over (check-up 45+) within a pilot project framework. We are evaluating the effects of the check-up 45+ on the utilization of preventive and rehabilitative services in the pilot project of GPI Bavaria South. METHODS: The GPI agency selected individuals based on inclusion criteria and randomized them into either the intervention group (IG) or the control group (CG). Data on personal characteristics and service utilization are available in the administrative data of the GPI and are supplemented by additional case documentation for the IG. We conducted descriptive and inferential statistical analyses using intention-to-treat (ITT) and per-protocol (PP) approaches. RESULTS: The study includes 20,229 individuals (IG: 10,106; CG: 10,123), with 4.5% of the IG participating in the check-up 45+. In the ITT, the application rate for preventive services is six times higher in the IG than in the CG (p < .001), while for rehabilitative services, it is 1.2 times higher (p ≤ .01). In the PP, effects are more pronounced for both preventive (RR = 110.8, p < .001) and rehabilitative (RR = 2.9, p < .001) services. Participation in the check-up 45+ significantly influences the timing of preventive service applications while this effect is less pronounced for rehabilitative services. CONCLUSION: This pilot strategy effectively identifies previously unrecognized needs for prevention or rehabilitation and increases service utilization. However, it primarily targets individuals with a low risk of premature workforce exit.
Implementing the GUideline for Intervention DEscription in Rehabilitation (GUIDE-Rehab) Within Work Disability Prevention Research.
Gross DP, Findley PA, Nowrouzi-Kia B … +4 more , Kristman VL, Côté P, Whyte J, Negrini S
J Occup Rehabil · 2026 Jun · PMID 41670796 · Publisher ↗
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Experiences in Treatment, Recovery, and Return-to-Work Following an Acute Cardiac Event Among Firefighters: A Descriptive Thematic Analysis of Firefighter Experiences.
Stretton SM, MacDermid JC, Attalla JW … +2 more , MacPhee R, Walton DM
J Occup Rehabil · 2026 Feb · PMID 41661488 · Publisher ↗
BACKGROUND: Heart disease is the leading cause of death and disability worldwide and includes any disease affecting the heart or blood vessels. Stress has been widely cited as a potential factor in the development of hea...
BACKGROUND: Heart disease is the leading cause of death and disability worldwide and includes any disease affecting the heart or blood vessels. Stress has been widely cited as a potential factor in the development of heart disease and acute cardiac events. Firefighters may be at a higher risk of developing heart disease and experiencing an acute cardiac event due to the high mental and physical demands of the job. There is limited literature on treatment, recovery, and how to successfully return to this high-stress work environment. This study explored the recovery, treatment, and return-to-work (RTW) process following acute cardiac events experienced by firefighters, with a specific focus on psychological stress and mental health. METHODS: We recruited nine firefighters who had an acute cardiac event during their career. Firefighters participated in a semi-structured interview with a critical theory paradigm that explored their experience during treatment, recovery, and RTW. Data were analyzed in a two-reviewer process using thematic analysis. RESULTS: Thematic analysis revealed four major themes: (1) there is a lack of consideration of what it means to be a firefighter during treatment and recovery; (2) mental health difficulties are overlooked and a major barrier to recovery and RTW; (3) mental and physical illness stigma within the fire organization impedes a successful recovery and RTW; and (4) social support is critical to a successful recovery and RTW. CONCLUSION: The results of this study highlighted a pressing need for formalized fire-specific treatment, recovery, and return-to-work processes to ensure a successful return.
Evaluating the Validity of the GM@W Survey: A Psychometric Study Across Gender and Industry.
Mencia-Ledo J, Siddiqui S, Lau HKC … +7 more , Balakrishnar K, Dos Santos ALFA, Villarreal Galeano AV, Zhou L, Cooper M, Betini GS, Nowrouzi-Kia B
J Occup Rehabil · 2026 Jan · PMID 41619121 · Publisher ↗
PURPOSE: The National Workplace Psychological Health and Safety Standard (The Standard) recommends the use of a survey developed by Guarding Minds at Work (GM@W). However, its validity remains underexplored. This study h...
PURPOSE: The National Workplace Psychological Health and Safety Standard (The Standard) recommends the use of a survey developed by Guarding Minds at Work (GM@W). However, its validity remains underexplored. This study has two objectives: (1) to evaluate the psychometric properties of the survey in assessing the Standard dimensions and (2) to examine validity across gender and industry. METHODS: A Confirmatory Factor Analysis (CFA) was conducted on data from the GM@W survey to evaluate the factor structure and validity of the 13 dimensions. Group comparisons by gender and occupational groups were assessed using t-tests and ANOVA tests. RESULTS: Across the 13 dimensions, most items demonstrated strong internal consistency and discriminant validity, with physical safety (r = 0.71) and organizational culture (r = 0.68) showing the highest internal consistency. While psychological competencies and physical safety were linked to positive mental health outcomes, challenges with workload management and balance remain prominent, especially for workers in healthcare and education. Group differences were observed, with women and workers in business, trades, and manufacturing reporting better psychosocial outcomes. DISCUSSION: While the GM@W tool demonstrated internal consistency and improved convergent validity compared to previous versions, significant model misfit was observed across all sectors. High latent correlations and frequent violations of the Fornell-Larcker criterion reveal substantial construct overlap and empirical redundancy. The findings suggest that while individual constructs are reliable, the 13-factor structure faces challenges in achieving empirical distinctiveness. Capturing the diverse psychosocial experiences of a national workforce within a single psychometric instrument remains a complex task.
Correction to: Update on Individual Placement and Support for New Populations: A Meta-analytic Review.
Bond GR, Drake RE, Becker DR
J Occup Rehabil · 2026 Mar · PMID 41563557 · Publisher ↗
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