Journal Of Occupational Rehabilitation[JOURNAL]
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200 papers
Why are Disclosure Decisions so Difficult? Understanding Factors that Encourage and Discourage Workers with a Chronic Disabling Condition from Disclosing Health Information at Work.
Gignac MAM, Bowring J, Saunders R … +7 more , Navaratnerajah L, Smith PM, Jetha A, Thompson A, Franche RL, Shaw WS, Pienkowski M
J Occup Rehabil · 2025 Aug · PMID 40880026 · Publisher ↗
PURPOSE: The decision whether to disclose a disability at work is complex. Drawing on communication theories, we examined disclosure decision-making and how workers with disabling health conditions prioritized informatio...
PURPOSE: The decision whether to disclose a disability at work is complex. Drawing on communication theories, we examined disclosure decision-making and how workers with disabling health conditions prioritized information that could simultaneously encourage and discourage disclosure. METHODS: An online, cross-sectional survey asked workers with physical and mental health/cognitive conditions creating job limitations (i.e., disability) at work about the health impacts on their employment, their disclosure goals, preferences, support availability, workplace culture, work context, and demographic information. Descriptive, multivariate, and latent profile analyses were used. RESULTS: Participants were 591 workers (51% men, 48% women, 1% non-binary) with physical (41%), mental health/cognitive (24%), or both groups of conditions (35%). Forty-two percent of participants had not disclosed health information or needs to their supervisor. Six profiles of decision patterns were identified: (1) little health impact, supports available; (2) some health impacts, positive support appraisals; (3) some health impacts, uncertain what to do; (4) some health impacts, considerable personal concerns; (5) little health impact, few concerns, few supports available; and (6) considerable health impacts but perceives many risks to sharing. Disclosure decisions often prioritized personal goals, preferences, and workplace culture over health impacts and support availability. Profiles were differentiated by health condition type and work context. CONCLUSION: Understanding how workers prioritize information when considering disclosing a disability at work has implications for organizational support practices and clinical efforts to support workers. It underscores that worker decisions go beyond health impacts and highlights the need for support resources to help workers address decision uncertainty and stress.
Barriers and Facilitators of Implementing Workplace Interventions Supporting Young Workers' Safety, Work Environment and Health: A Scoping Review of Qualitative and Mixed-Method Studies.
Sundstrup E, Dyreborg J, Frost AD … +3 more , Seeberg KGV, Andersen LL, Clausen T
J Occup Rehabil · 2025 Aug · PMID 40848230 · Publisher ↗
PURPOSE: Young workers face higher risks of workplace accidents, mental health issues, and physical strain. This scoping review aims to identify and summarize available research literature on barriers and facilitators to...
PURPOSE: Young workers face higher risks of workplace accidents, mental health issues, and physical strain. This scoping review aims to identify and summarize available research literature on barriers and facilitators to implementing workplace interventions to support young workers' safety, work environment and health. METHODS: We conducted a comprehensive search in bibliographic databases including PubMed, Web of Science and PsycInfo for articles published from 2007-2022. The PICO strategy guided the assessment of relevant studies and the bibliographical search for qualitative and mixed-method studies on interventions where (1) participants were young workers (mean age 15-29 years), (2) interventions were initiated and/or carried out at the workplace, and (3) barriers or facilitators to the implementation of interventions to support young workers' safety, work environment and health were described. We employed an iterative process to identify general thematic categories in the data. RESULTS: In total, 11 relevant studies were identified. Seven primary themes related to facilitators and barriers emerged from our analysis. Facilitators: fit the organizational context, organizational support, balance between efforts and gains, employee motivation, and employee involvement; Barriers: high workload and time pressure, shift work and irregular working hours. CONCLUSION: There is a lack of intervention studies on young workers focusing on factors for implementation. The studies we find, reveal several factors to be aware of when designing and implementing interventions to support young workers' safety, work environment and health. The results emphasize a need for studies evaluating factors of importance for the successful implementation of workplace-based interventions among young workers. REVIEW REGISTRATION: PROSPERO CRD42022324299 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324299 ).
Toward the Search for Clinical and Cognitive Variables that Affect Employment in LATAM: a Multicenter Study.
Vanotti S, Jaworski M, Ayala OD … +10 more , Román MS, González FM, Abulafia C, Iglesias Passada J, Bardoneschi L, Saladino ML, Cáceres F, Macías Islas MÁ, Benedict RHB, Qol-LATAM Group
J Occup Rehabil · 2025 Aug · PMID 40826316 · Publisher ↗
BACKGROUND: In response to rising unemployment rates among people with multiple sclerosis (PwMS) and poor working conditions in Latin America (LATAM), MS experts established the Quality-of-Life working group. This study...
BACKGROUND: In response to rising unemployment rates among people with multiple sclerosis (PwMS) and poor working conditions in Latin America (LATAM), MS experts established the Quality-of-Life working group. This study aims to: (i) describe occupational outcomes and employment status among PwMS in LATAM; (ii) investigate the relationship between different levels of disability and ES; and (iii) Quantify accommodation use and explore potential clinical, cognitive, and sociodemographic predictors of job accommodations in LATAM. METHODS: A total of 86 PwMS were recruited from Argentina, Chile, Colombia, Mexico, and Paraguay, of whom 79 (91%) had a relapsing-remitting phenotype and 61 (70.9%) were women. The assessment protocol included the Brief Visual Memory Scale (BVMS), the Brief International Cognitive Assessment for MS (BICAMS), the MS Neuropsychology Screening Questionnaire, the Beck Depression Inventory II (BDI-II), the Fatigue Severity Scale (FSS), and a socioeconomic status (SES) survey. RESULTS: (i) Based on employment status characteristics, 47 PwMS (54.6%) were classified into the work-stable group, 18 PwMS (20.9%) into the work-challenged group, and 21 PwMS (24.4%) into the work-loss group, additionally clinical and sociodemographic characteristics are described. (ii) Hierarchical cluster analysis ranked PwMS into three groups based on cognitive and physical disability levels, showing that a lower level of disability was linked to a higher likelihood of maintaining stable employment. (iii) Job accommodations were predicted by greater self-awareness of cognitive impairment, higher socioeconomic status, higher education, and higher physical disability, all contributing to increased use of workplace accommodations. CONCLUSION: Physical and neuropsychological disability increase the likelihood of being classified in the work-loss group, while factors such as self-awareness of cognitive impairment, socioeconomic status, level of disability, and education are associated with greater utilization of job accommodations. The work-loss rate among PwMS in LATAM was nearly three times higher than the general unemployment rate, underscoring the significant impact of MS on employment.
Employer Retention Profiles of Workers with Physical Disabilities.
Choi H, Wong J, Kudla A … +6 more , Crown DS, Yang B, Dinelli EJ, Capraro P, Trierweiler R, Heinemann AW
J Occup Rehabil · 2025 Aug · PMID 40819115 · Publisher ↗
PURPOSE: This study aimed to define parsimonious, non-overlapping subgroups of employers based on perceived facilitators and challenges in retaining workers with physical disabilities. Additionally, we sought to compare...
PURPOSE: This study aimed to define parsimonious, non-overlapping subgroups of employers based on perceived facilitators and challenges in retaining workers with physical disabilities. Additionally, we sought to compare company characteristics, disability-related supports and practices, and job accommodation provision across employer subgroups. METHODS: We conducted a cross-sectional observational study using an online survey among 2,000 employers in the United States. Data analysis included 1,641 employers who hired at least one worker with a physical disability. Data analysis methods included latent profile analysis, independent t test, and chi-square or Fisher's exact test. RESULTS: We identified two subgroups of employers, characterized by high facilitator (n = 360) and high challenge groups (n = 1,281). The high facilitator group consists of employers who perceive greater facilitators than challenges in retaining workers with disabilities, while the high challenge group consists of employers who perceive greater challenges than facilitators. A greater proportion of respondents in the high facilitator group were from service-providing companies, had fewer than 500 employees, and were CEOs or owners, compared to those in the high challenge group. Additionally, the high facilitator group reported higher rates of hiring workers with disabilities over the past 12 months, greater implementation of disability-related supports and practices, and greater provision of job accommodations than the high challenge group. CONCLUSION: Employers can enhance the retention of workers with physical disabilities by promoting facilitators and addressing challenges, strengthening disability-related supports and practices, and providing job accommodations. Future research should validate these findings and develop targeted interventions.
A Scoping Review of Vocational Rehabilitation Programs for People with Acquired Physical Disabilities.
Mohamad NBZ, Tan GYQ, Lim SAY … +2 more , Joe S, Asano M
J Occup Rehabil · 2025 Aug · PMID 40815325 · Publisher ↗
PURPOSE: Well-designed vocational rehabilitation programs (VRPs) are needed to ensure that people with acquired physical disabilities (PAPD) receive the optimal support to return to work. The aim of our scoping review wa...
PURPOSE: Well-designed vocational rehabilitation programs (VRPs) are needed to ensure that people with acquired physical disabilities (PAPD) receive the optimal support to return to work. The aim of our scoping review was to summarize the literature on both international and local VRPs that support PAPD to return to work. METHODS: We conducted a scoping review based on Arksey and O'Malley's framework. We searched databases (PubMed, CINAHL, and PsycINFO) throughout March 2023. To be included, studies must have been published in a peer-reviewed scientific journal, be available in the English language, and describe a VRP for PAPD. We added a grey literature search to better understand local VRPs. We summarized the VRPs' characteristics and services narratively. RESULTS: We screened 2894 citations and included 20 in our review. These 20 articles discussed 16 VRPs. We identified 46 unique service components and categorized them into six domains - vocational, physical, financial, social, psychological, and others. The vocational domain comprised the majority of components identified (n = 18, 40%). However, no VRPs were exactly alike. CONCLUSION: VRPs facilitate PAPD to return to work via a range of services. Our review is useful for vocational rehabilitation providers to enhance existing VRPs or to design new ones. We recommend that VRPs offer a set of standardized services with the option of expanding services based on emerging needs of service users. Our scoping review provides a valuable evidence synthesis of the services offered within the field of vocational rehabilitation. Future research to better understand the effectiveness of VRPs is warranted.
Return to Work or Not: The Paths to Psychiatric Disability and Back.
Rissanen P, Pirkola S, Näppilä T … +4 more , Karolaakso T, Leppänen H, Fröjd S, Autio R
J Occup Rehabil · 2025 Aug · PMID 40788560 · Publisher ↗
OBJECTIVES: Mental health-related work disability has increased in Europe, despite efforts to promote individuals´ work ability. We examined individuals´ occupational status before and after a psychiatric disability pens...
OBJECTIVES: Mental health-related work disability has increased in Europe, despite efforts to promote individuals´ work ability. We examined individuals´ occupational status before and after a psychiatric disability pension (DP). METHODS: The study comprises individuals granted a DP for the first time between 2010 and 2012 in Finland (N = 18,373). We used modern methods to cluster the sequences of individuals´ occupational status before and after temporary (n = 8615) or permanent (n = 9758) psychiatric DP. We compared socioeconomic, illness and health care system-related factors between nine groups, formed by sequence analysis utilizing multinominal regression analysis. RESULTS: The analysis identified typical groups of temporary pensioners: after steady working careers, periods of unemployment and from mixed states. Severity of health and mental health problems, socioeconomic and occupational status, pension system-related factors as well as treatment or rehabilitation varied between the groups. Individuals with temporary DPs (tDP) appeared mainly to either remain disabled (74% of the study tDP) or return to the same status they had before disability: to work (17%) or unemployment (8%). A steady working career, high education and received psychotherapy and rehabilitation all promoted returning to work. Among young adults, severity of the illness and lack of occupational education were risk factors for long-term disability. CONCLUSIONS: Among those with tDP, circles of disadvantage may exist. They relate to unemployment, poor mental and somatic heath, low education, poverty, and failure of rehabilitative efforts. Especially young adults with severe mental disorders require not only rehabilitation but also educational support.
Assessing Functional Limitations in Workers with a Common Mental Disorder or a Musculoskeletal Disorder: A Scoping Review of Questionnaires.
Lépine Lopez A, Sauvé G, Corbière M
J Occup Rehabil · 2025 Aug · PMID 40768120 · Publisher ↗
PURPOSE: Approximately, 80% of sick leave involve workers dealing with a common mental disorder (CMD) or a musculoskeletal disorder (MSD). Upon returning to work (RTW), these workers may encounter challenges, including f...
PURPOSE: Approximately, 80% of sick leave involve workers dealing with a common mental disorder (CMD) or a musculoskeletal disorder (MSD). Upon returning to work (RTW), these workers may encounter challenges, including functional limitations at work. However, assessing these limitations is complex. This study aims to map existing questionnaires that evaluate functional limitations in individuals with CMD or MSD. METHODS: A scoping review was conducted following the methods of the Joanna Briggs Institute's (JBI) Scoping Reviews Methodology Group, utilizing five databases: ProQuest, EBSCO, Scopus, Cochrane, and PsycNET. Articles were included if they presented a questionnaire evaluating functional limitations or related concepts in individuals with CMD or MSD. RESULTS: A total of 541 articles were identified, with 6 articles selected after the screening process. The most frequently assessed dimensions in the selected questionnaires were physical (in 5 tools) and cognitive (in 3 tools). A thematic analysis was performed to develop a unified classification of dimensions and identify various types of functional limitations, addressing the inconsistent terminology across the questionnaires. CONCLUSION: Physical limitations seem to be more objective and easier to assess than psychological limitations. Future research should focus on psychological limitations to enhance understanding among healthcare professionals and individuals with CMD or MSD.
Present but Overlooked: A Scoping Review of Instruments and Approaches for Measuring Presenteeism Related to Alcohol, Tobacco, and Drug Use.
Thompson K, Ahad MA, Di Censo G … +4 more , Hines S, Rich N, McEntee A, Bowden J
J Occup Rehabil · 2026 Mar · PMID 40745493 · Full text
PURPOSE: The use of alcohol, tobacco, and other drugs (ATOD) can impact workplace productivity. Whilst presenteeism has a greater impact on productivity than absenteeism, it is less visible and often receives less attent...
PURPOSE: The use of alcohol, tobacco, and other drugs (ATOD) can impact workplace productivity. Whilst presenteeism has a greater impact on productivity than absenteeism, it is less visible and often receives less attention. Measuring ATOD-related presenteeism is important for identifying the impact of AOD use and evaluating workplace AOD interventions. However, there is no standard approach to determining ATOD-related presenteeism. The aim of this scoping review was therefore to identify and describe different approaches and instruments used to determine ATOD-related presenteeism. METHODS: A scoping review of publications up to and including December 2024 was undertaken across three major databases: Scopus, Ovid Medline, and the Latin-American and Caribbean System on Health Sciences (LILACS). The population was workers for whom ATOD-related presenteeism was reported, the concept was presenteeism, and the context was the workplace. RESULTS: The review included 27 original studies. The most common approach (n = 22 studies) was indirect, which involved examining differences in presenteeism between workers who did and did not use ATOD. Direct approaches-asking participants explicitly about their ATOD-related presenteeism-were less common (n = 5 studies) and focussed exclusively on alcohol. Across both approaches, there was substantial variation in instruments (n = 4 direct, n = 10 presenteeism, n = 18 ATOD), use of validated instruments, recall periods, and ways of reporting findings, which may compromise the interpretation and synthesis of studies. CONCLUSION: This scoping review provides an evidence base for informing approach and instrument selection. It establishes the need for further research on the impact of different approaches and instruments on findings. This information is essential to encourage more rigorous and standardised approaches to determining ATOD-related presenteeism and evaluating workplace interventions.
Facilitating Return to Work through a Broader Perspective on Vocational Rehabilitation: Insights from Patients with Stress-Related Disorders.
Beno A, Jonsdottir IH, Lindegård A
J Occup Rehabil · 2025 Jul · PMID 40739051 · Publisher ↗
BACKGROUND: Exhaustion disorder (ED) is a prevalent cause of sick leave in Sweden, and support from employers appears to facilitate return to work (RTW). The aim of this study was to explore and highlight what patients d...
BACKGROUND: Exhaustion disorder (ED) is a prevalent cause of sick leave in Sweden, and support from employers appears to facilitate return to work (RTW). The aim of this study was to explore and highlight what patients diagnosed with ED thought would have been beneficial for their RTW, on the individual level, on the workplace level and at the organisational level. METHODS: Twenty patients were invited to participate in an interview conducted seven years after they sought care. The semi-structured interviews were transcribed verbatim and analysed using inductive content analysis. RESULTS: The analysis revealed an overarching theme "A need for a holistic view of the RTW process" and three main categories emerged: "The importance of a well-prepared organisation", "What characterises a good leader?" and "Meeting the needs of each employee". Important findings were that adjustments are warranted on an organisational level. Leadership qualities such as having a supportive approach and authority to make changes were highlighted. On an individual level, influence on their work situation and tailored adjustments was essential. For most patients change of work situation, such as change of workplace, work tasks and reduced working hours were necessary. CONCLUSION: To facilitate RTW for patients with ED, it is essential to have a holistic approach that recognises necessary organisational changes, management support and individually tailored adjustments.
Cluster Analysis Reveals Subgroups with Different Risk Profiles and Sickness Absence Patterns in an Occupational Health Cohort.
Anttila A, Nuutinen M, Leskelä RL … +3 more , van Gils M, Pekki A, Sauni R
J Occup Rehabil · 2025 Jul · PMID 40730933 · Publisher ↗
PURPOSE: Using unsupervised and supervised machine learning methods, we aimed to identify clinically relevant groups of employees with similar characteristics and analyze the association of long and short sickness absenc...
PURPOSE: Using unsupervised and supervised machine learning methods, we aimed to identify clinically relevant groups of employees with similar characteristics and analyze the association of long and short sickness absence periods with these groups. METHODS: The participants were 12,099 employees of various occupations in Finnish companies. The data comprised 104 variables from medical records including data on sickness absences and a questionnaire used between 2011 and 2019 in health examinations. The latent dimensions for the employees were defined by principal component analysis to reduce the number of variables. Clusters were calculated using the K-means algorithm from datapoints expressed by the resulting five principal components. Logistic regression analyses were used to assess the associations of the clusters with long (> 30 days) and repetitive short (1-10 days) sickness absence (SA) episodes. RESULTS: Employees in cluster one indicated positive managerial performance and workplace atmosphere, and employees had the least of both short and long SA. Cluster two indicated deficiencies related to managerial performance and workplace atmosphere. Cluster three had deficiencies mainly related to mood and depression and cluster four had cardiovascular diseases. Employees in cluster five reported many symptoms, especially dizziness and sensory symptoms, and had the highest occurrence of repetitive short SA. Cluster six indicated deficiencies related to work ability and had the highest occurrence of a long SA episode during follow-up. CONCLUSION: Unsupervised and supervised machine learning methods identified six clinically coherent employee clusters, providing information on typical combinations of characteristics and risk profiles of sickness absence.
Disability, Job Satisfaction, and Workplace Accommodations: Evidence from the Healthcare Industry.
van der Meulen Rodgers Y, Schur L, Hammond FM … +3 more , Edwards R, Cohen J, Kruse D
J Occup Rehabil · 2025 Jul · PMID 40721694 · Publisher ↗
PURPOSE: This paper examines the extent to which job satisfaction, requests for accommodations, and the likelihood of a request being granted vary by disability status. We further analyze whether being granted workplace...
PURPOSE: This paper examines the extent to which job satisfaction, requests for accommodations, and the likelihood of a request being granted vary by disability status. We further analyze whether being granted workplace accommodations moderates the relationship between work satisfaction and disability. METHODS: We use a novel survey of healthcare workers centered on disability status, perceptions of work experiences, and the provision of accommodations. The data are used in a descriptive analysis and multiple regressions to examine the moderating effect of accommodations on the relationship between disability and indicators related to job satisfaction. RESULTS: Results show that people with disabilities have more negative perceptions of their work experiences than people without disabilities. Although people with disabilities are more likely to request accommodations than people without disabilities, they are equally likely to have their requests wholly or partly granted. Regression results indicate that the negative relationships between disability status and most measures of work experience are largely eliminated when accounting for the disposition of accommodation requests. The main exception is turnover intentions, in which the adverse relationship with having a disability does not change even when an accommodation is granted. Partly granting accommodations is helpful only for some metrics of job experience. CONCLUSION: Our paper shows that fully granting accommodations can go a long way to closing the disability gap in job satisfaction between people with and without disabilities.
Description of Managers' Competencies in Diversity, Equity, and Inclusion: A Scoping Review.
Lecours A, Laliberté M, Drolet AA … +9 more , Bellehumeur-Béchamp L, Bédard-Mercier R, Drolet MJ, Turcotte S, Gauthier-Boudreault C, Vincent C, Lord MM, Kiss J, Feillou I
J Occup Rehabil · 2025 Jul · PMID 40699259 · Publisher ↗
PURPOSE: Organizations are increasingly integrating a diverse workforce, bringing both opportunities and challenges. To harness the benefits of diversity while addressing its complexities, the adoption of diversity, equi...
PURPOSE: Organizations are increasingly integrating a diverse workforce, bringing both opportunities and challenges. To harness the benefits of diversity while addressing its complexities, the adoption of diversity, equity, and inclusion (DEI) principles is essential. These principles are particularly important in ensuring optimal accommodation for people returning to work after a period of disability, to take account of their multifaceted realities. Managers are pivotal in implementing and overseeing these initiatives, yet their specific roles and the required competencies remain underexplored. This study aimed to provide a comprehensive overview of the competencies managers need to effectively uphold DEI principles. METHODS: We conducted a scoping review to collect and analyze information from 21 manuscripts, following a systematic five-step process. RESULTS: The analysis identified seven core competencies and 28 sub-competencies that managers must exhibit to promote DEI in organizations. The seven competencies include the following: (1) communicating effectively with individuals; (2) managing DEI-related conflicts with diligence; (3) identifying and improving personal challenges related to DEI; (4) demonstrating transparency toward individuals; (5) acting as a role model to promote DEI at all levels; (6) facilitating the full potential of individuals; and (7) creating a team dynamic that fosters a sense of belonging for all individuals. CONCLUSION: This study underscores the critical role managers play in fostering inclusive environments, not only by promoting diversity but also by implementing fair workplace accommodations that facilitate the return to work of employees following a period of disability. This framework provides a foundation for future research on managerial practices in DEI.
Job Accommodations for People with Physical Disabilities: Findings of a United States National Survey.
Crown DS, Dinelli EJ, Kudla A … +5 more , Capraro P, Wong J, Trierweiler R, Sheth M, Heinemann AW
J Occup Rehabil · 2025 Jul · PMID 40679577 · Publisher ↗
PURPOSE: Identify the job accommodations associated with increased job retention and satisfaction for people with physical disabilities. METHODS: A national survey of 1265 people with physical disabilities in the United...
PURPOSE: Identify the job accommodations associated with increased job retention and satisfaction for people with physical disabilities. METHODS: A national survey of 1265 people with physical disabilities in the United States, who worked for an employer after their disability onset. The sample was 58% males, average age of 44 years, 74% white, and worked an average of 36 h weekly. We assessed frequency, type, and use of job accommodations and used multivariate Poisson regression to evaluate the relationship between job accommodations, job tenure, and satisfaction. RESULTS: The top job accommodations were modified work schedules, modified policies/rules, job sharing, allowing sitting/standing changes, and unpaid leave. The job accommodations needed but not received were limiting lifting, pushing, pulling; co-worker assistance; limiting twisting, bending; using modified/new equipment; and telework. Males reported higher frequency of accommodation use than females, while females reported not needing accommodations more often. Among respondents who used an accommodation, 82% rated it as moderately or very helpful. Most respondents (79%) reported that they were satisfied or very satisfied with their jobs. Poisson regression models revealed an association between using a job accommodation and job tenure for 4 years or longer for all job accommodation categories, with an increased likelihood of job tenure beyond 4 years by 10-70%. Four of 12 job accommodation categories were associated with job satisfaction. CONCLUSIONS: Use of employer- and self-provided job accommodations is associated with longer job tenure and increased job satisfaction. Each person, job, and environmental factor provides opportunities to tailor accommodations.
"He was Threatened and Told to Cooperate": Immigrant Worker Experiences with the Workers' Compensation System in the Canadian Context.
Senthanar S, Ahmadi B, Creese G … +3 more , Marino S, McLeod CB, Koehoorn M
J Occup Rehabil · 2025 Jul · PMID 40624384 · Publisher ↗
PURPOSE: To understand immigrant workers' experiences when navigating the workers' compensation system for access to benefits following a work injury or illness. METHODS: Interviews were conducted with 17 injured immigra...
PURPOSE: To understand immigrant workers' experiences when navigating the workers' compensation system for access to benefits following a work injury or illness. METHODS: Interviews were conducted with 17 injured immigrant workers recruited in British Columbia through partnerships with settlement organizations, social media and professional networks. A situational analysis approach was used to analyze interview data and to identify contextual reasons for immigrant workers' experience with the workers' compensation system. FINDINGS: The findings describe a tension between how the workers' compensation system is intended to work and how injured immigrant workers experienced the system. Workers described challenges with accessing and communicating with their case managers for timely access to benefits, work accommodation that did not align with their needs and disrupted their rehabilitation, and complicated claim trajectories stemming from perceptions of procedural unfairness. Immigrant workers described how these experiences were perpetuated by their different contexts including language barriers, unfamiliarity with the workers' compensation system, and their identity as immigrant workers. CONCLUSION: This study identifies contextual factors for the experiences of immigrant workers, within the Canadian context, for consideration by workers' compensation system in the management of injury and illness to reduce inequities where they may exist.
What Works (or Doesn't) in Return to Work after Physical Injury? A Qualitative Study on the Perspectives of Trauma Patients and Health Care Professionals on Barriers and Facilitators in Return to Work.
de Groot E, Hermans AM, de Jongh MAC … +8 more , Geuze RE, van Dongen IM, Hommes S, Vromans RD, Krahmer E, Houwen T, Janssens KME, Joosen MCW
J Occup Rehabil · 2025 Jul · PMID 40617990 · Publisher ↗
PURPOSE: Return to work (RTW) after physical injury may be challenging. This study aims to gain insight into barriers and facilitators in RTW, using a multi-stakeholder perspective from trauma patients with diverse injur...
PURPOSE: Return to work (RTW) after physical injury may be challenging. This study aims to gain insight into barriers and facilitators in RTW, using a multi-stakeholder perspective from trauma patients with diverse injuries and health care professionals (HCPs). METHODS: Three focus groups (n = 13) and four interviews were conducted with patients who sustained an extremity injury, spinal injury, or traumatic brain injury. Four focus groups (n = 19) were conducted with HCPs (e.g., occupational physicians, trauma surgeons). Data were transcribed verbatim and thematically analyzed for patients and HCPs separately. RESULTS: Both patients and HCPs emphasized that RTW can be influenced by the extent to which core work tasks are affected by the injury. Barriers in RTW related to lack of RTW follow-up care, limited consultation time, and lack of support in the work environment. Shared facilitators were found in work not affecting the injury, and when adequate support is provided by HCPs and the work environment. While patients and HCPs shared similar ideas, perspectives diverged on RTW follow-up care, provided by HCPs in hospital. HCPs in hospital perceive physical recovery as their core task instead of RTW follow-up care, which is perceived by patients to detract attention to life after injury. CONCLUSION: According to patients and HCPs, regardless of the injury, the combination of injury type and job type influences RTW. Across injuries, receiving RTW follow-up care from HCPs in hospital was often missed, while perceived to facilitate RTW. Tailored RTW information could be useful to patients in resuming life after injury.
Mapping Vocational Rehabilitation Interventions for People with Chronic Low Back Pain: A Scoping Review.
Frydenlund G, O'Neill S, Mortensen OS … +2 more , Søndergaaard J, Hansen A
J Occup Rehabil · 2026 Mar · PMID 40601226 · Full text
PURPOSE: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Clinical guidelines recommend multidisciplinary rehabilitation for managing chronic LBP. This scoping review maps vocational reh...
PURPOSE: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Clinical guidelines recommend multidisciplinary rehabilitation for managing chronic LBP. This scoping review maps vocational rehabilitation (VR) interventions delivered within the healthcare sector for individuals with chronic LBP. It explores (1) which professional groups are involved and how they collaborate, (2) the setting, (3) the duration, intensity, and components of interventions, and (4) how work status is assessed. METHODS: A systematic search across six databases (MEDLINE, Embase, CINAHL, AMED, OT Seeker, and Scopus) was conducted in September 2023 and updated in October 2024, following PRISMA-ScR guidelines. Studies were included if they involved working age individuals with chronic LBP receiving VR initiated within the healthcare sector. Articles published before 2013, from outside Europe, or with > 50% of participants on sick leave > 12 months were excluded. RESULTS: Of 7032 records, 26 articles representing 21 studies from seven European countries were included. Interventions varied in duration (1-12 weeks or until return-to-work (RTW) or a new plan was established), intensity (a few hours to 30 h/week), complexity, and follow-up periods (5 weeks to 5 years). Interdisciplinary collaboration was most common (six studies), although descriptions were limited. Interventions ranged from simple to complex, with up to seven components. Nineteen different methods were used to assess work status. CONCLUSION: Substantial heterogeneity in intervention design and RTW outcome measures limits comparability and evidence synthesis. Clearer definitions of collaboration and standardized RTW reporting are needed to inform future development of VR in healthcare contexts.
The Experience of Return to Work Among People with Persistent Symptoms Following a Concussion: An Interview Study.
Vierø K, Pedersen LL, Hartvigsen J … +1 more , Primdahl J
J Occup Rehabil · 2025 Jun · PMID 40588625 · Publisher ↗
PURPOSE: This study aimed to explore the experiences of Danish adults experiencing persistent symptoms following a concussion with a focus on their return to work (RTW) process. METHODS: We employed a phenomenological-he...
PURPOSE: This study aimed to explore the experiences of Danish adults experiencing persistent symptoms following a concussion with a focus on their return to work (RTW) process. METHODS: We employed a phenomenological-hermeneutic approach, using semi-structured interviews with seven persons with persistent symptoms following a concussion from two Danish municipalities. Data were analyzed using reflexive thematic analysis. RESULTS: The analysis derived four main themes: (1) The importance of understanding and consideration from others. The participant's quality of life and RTW outcomes were influenced by the level of understanding and consideration they received from others. (2) Balancing needs and limitations. The participants struggled to balance their desire to work with their limited ability, which resulted in feelings of pressure and guilt towards their families. (3) Experiencing random support. The participants experienced random support from stakeholders and lack of guidance from the healthcare system. (4) A sense of loneliness, due to their inability to tolerate being around others. CONCLUSION: Recognition in daily life seem to play a key role in the RTW process for individuals with persistent symptoms following a concussion. They struggle to balance their limitations to match their desire to both work and family life. The support they received was often random and they felt lonely. The findings reflect the participant's desire for structured and recognition-based rehabilitation and support to enhance their daily lives and facilitate the RTW process.
Effect of Cognitive Behavioural Stress Management on Return-to-Work Amongst Sick-Listed Employees.
Bond CB, Willert MV, Ditlevsen DN … +2 more , Sandal LF, Brandt L
J Occup Rehabil · 2025 Jun · PMID 40560356 · Publisher ↗
BACKGROUND: The literature provides contradictory information on the effect of cognitive behavioural therapy (CBT) interventions on return to work (RTW) for patients on sick leave due to work-related stress. AIM: We comp...
BACKGROUND: The literature provides contradictory information on the effect of cognitive behavioural therapy (CBT) interventions on return to work (RTW) for patients on sick leave due to work-related stress. AIM: We compared the cumulative number of sick leave weeks between a cohort of patients who received a CBT-based stress management intervention in the period 2011-2018 (N = 331) and a cohort of patients from 2010 to 2011 (N = 221) who did not receive the intervention. We also compared time until sustainable RTW (3 consecutive months of no sick registrations) between the cohorts. METHODS: Registry data on sickness absence were obtained from the national DREAM register (Danish Public Transfer Payments Database). The cumulative time of registered sick leave in DREAM until first sustainable period of RTW was visualized using Kaplan-Meier plots. A Cox proportional hazard model was used to compare the effectiveness of the intervention relative to the comparison cohort and was reported as hazard rate ratio. RESULTS: The intervention cohort's cumulated number of weeks in DREAM across the total period from 0 to 36 months (median 29 range 26-32) was lower than that of the comparison cohort (median 40 range 34-52), (P = 0.005), corresponding to a 14% (95% CI 0.04-0.24) reduction. For RTW, a hazard ratio rate of 1.25 (95% CI 1.02-1.54) favouring the intervention group was found (P = 0.034). CONCLUSION: The CBT stress management intervention significantly reduced the amount of sick leave and reduced the time until sustainable RTW for the intervention cohort compared to the comparison cohort.
Changes and Determinants of Health-Related Quality of Life in Patients with Work-Related Traumatic Musculoskeletal Injuries: A Longitudinal Analysis of HRQoL and the EQ-VAS.
Adrovic I, Coenen M, Simmel S … +1 more , Kus S
J Occup Rehabil · 2025 Jun · PMID 40549340 · Publisher ↗
PURPOSE: This study aims to analyze change over time in health-related quality of life and the current overall health status of patients with severe musculoskeletal injuries, specifically focusing on those who have under...
PURPOSE: This study aims to analyze change over time in health-related quality of life and the current overall health status of patients with severe musculoskeletal injuries, specifically focusing on those who have undergone inpatient rehabilitation following work-related injuries. METHODS: Data were sourced from the icfPROreha research project (DRKS-ID: DRKS00014857), involving a multicenter longitudinal study conducted across ten German clinics. The study population comprised patients who had sustained severe musculoskeletal work-related injuries. The EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) was used to assess changes in health-related quality of life (HRQoL) measured at admission (t1), discharge (t2), and four follow-up periods up to 78 weeks after discharge. Descriptive analyses were conducted to illustrate the development of HRQoL across all time points. In addition, the current overall health status was measured using the EuroQol Visual Analogue Scale (EQ-VAS) at the same time points. Multilevel growth models were used to analyze change over time in EQ-VAS scores, considering the biopsychosocial perspective of health as indicated by the International Classification of Functioning, Disability, and Health (ICF), developed by the WHO. RESULTS: In total, 698 patients [males: 75.2%; mean age 47.5 years (SD ± 12.3)] with severe musculoskeletal work-related injuries were included in the analyses. The mean EQ-VAS at baseline was 50.3 and the mean EQ-5D-5L index was 0.6. Descriptive analyses of the EQ-5D-5L showed significant improvements across all five dimensions of HRQoL after discharge, with the most pronounced changes observed in mobility and usual activities. Moreover, the study demonstrated a significant improvement in the EQ-VAS over time. Baseline EQ-VAS had a substantial influence on subsequent changes, with various factors such as psychological well-being, visible consequences and severity of injury affecting recovery outcomes. Notably, differences in health status over time were observed across different injury types. CONCLUSION: The study demonstrates significant enhancements in the current overall health status among patients with traumatic musculoskeletal injuries following workplace or commuting accidents during inpatient rehabilitation. Furthermore, these findings emphasize the application of the ICF framework in capturing the multidimensional aspects of patient recovery. Despite improvements, patients' health status did not reach the levels observed in the general population, indicating the need for ongoing support and targeted interventions to ensure long-term recovery.
Work Ability and Work Participation Statuses of the Working-Age Population in Finland: A Register-Based Clustering Study.
Siltala V, Henriksson M, Joensuu M … +3 more , Ervasti J, Ahola E, Turunen J
J Occup Rehabil · 2025 Jun · PMID 40481288 · Publisher ↗
PURPOSE: Work ability is a complex concept without a single golden standard measure. This study explores the possibility to use register data to form distinct work ability clusters and examine the levels of work particip...
PURPOSE: Work ability is a complex concept without a single golden standard measure. This study explores the possibility to use register data to form distinct work ability clusters and examine the levels of work participation between these clusters, while considering the co-occurrence of factors contributing to work ability within the population. METHODS: We used register data from a 90% sample of the Finnish working-age population in 2021 (ages 20-64, n = 2 920 099) to operationalize work ability based on literature. Employing K-Prototypes clustering, we identified distinct clusters of work ability. In this cross-sectional study, we then examined work participation by assessing the number of months spent in employment, unemployment, and receiving disability benefits within each cluster. RESULTS: The analysis resulted in 11 distinct clusters. The clusters differed from each other in age, sex, educational attainment, occupation, household size and family type, and health. The average number of months spent in different work participation statuses in 2021 varied across these clusters with employment ranging from 7.3 to 11.6 months, unemployment from 0.3 to 2 months, and disability benefits from 0.2 to 2 months per year. CONCLUSIONS: Operationalization of the multifaceted concept of work ability using register data resulted in the identification of different clusters within the Finnish working-age population. Differences in various work ability-related variables highlight the complexity of work ability. Notably, the variation in work participation statuses among these clusters underscores the nuanced ways in which these factors interact to influence employment, unemployment, and reliance on disability benefits.
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