A teaching model for work practice in occupational therapy

Given the global changes in how work is conceptualized, organized and performed [8], it is critical that graduating occupational therapists have an up-to-date knowledge of work and work practice. This article briefly explores the relative dearth of work practice courses in current occupational therapy curricula and presents the rationale for developing a model for teaching and learning about occupational therapy work practice. It introduces a client-centered and occupation-focused model developed for an undergraduate work practice course and describes the use of the model in a specific course. The model identifies eight common work-related areas of concern - values clarification, vocational exploration, vocational choice, job search, starting work, maintaining work, returning to work and leaving work. Occupational Therapy tools, techniques and programs which may be useful in addressing these concerns; and the environmental factors that influence therapist and client in addressing work issues are also part of the model. The article concludes with examples of topics and issues which could be explored using this teaching and learning model.     

A toolkit for MSDs prevention--WHO and IEA context

Many simple MSD risk management tools have been developed by ergonomists for use by workers and employers with little or no training to undertake injury prevention programs in their workplace. However, currently there is no "toolkit" which places such tools within an holistic, participative ergonomics framework and provides guidance on how best to use individual tools. It is proposed that such an holistic approach should entail initial analysis and evaluation of underlying systems of work and related health and performance indicators, prior to focusing in assessment of MSD risks stemming from particular hazards. Depending on the context, more narrowly focused tools might then be selected to assess risk associated with jobs or tasks identified as problematic. This approach ensures that biomechanical risk factors are considered within a broad context of organizational and psychosocial risk factors. This is consistent with current research evidence on work- related causes of MSDs.     

A survey of occupational therapy in Australian work practice

While the prevention and management of work-related injuries are major areas of practice for Australian occupational therapists, there has been little research on occupational therapy's contribution in these areas. This study examined the characteristics of current Australian occupational therapy practice in the work arena. A postal questionnaire was sent to 355 occupational therapists employed in work practice from six of the eight state or territory Occupational Therapy Associations. The questionnaire enquired about demographic details, service provision in the prevention, assessment and rehabilitation areas and further education needs in these areas. The responses of 125 (35%) therapists were analysed and show the services commonly offered in prevention, assessment and rehabilitation. The most commonly offered services included job analyses, workplace assessment and suitable duties programs. The results also indicate high levels of service provision in the workplace. In presenting the findings of the survey, current trends in international and Australian occupational therapy work practice are discussed along with suggestions for directions in future education, practice and research.     

Interventions to Developing Community Partnerships for HIV Prevention Planning

Abstract

Since 1985 the Centers for Disease Control and Prevention (CDC) have entered into a series of cooperative agreements with the states and territories of the United States to fund human immunodeficiency virus (HIV) prevention activities. In 1994, the CDC mandate shifted from using a central entity to plan HIV prevention programs throughout its jurisdictions to fostering partnerships among a central state or territorial agency, health departments in local counties, and community-based organizations. This article discusses and applies a model developed by social workers to facilitate HIV prevention community planning at the local level. The model used to facilitate community planning emphasizes the use of the social principles of empowerment, self-determination, ownership, and inclusion to foster the development of community-relevant HIV prevention plans. This approach resulted in the completion of a successful HIV prevention plan, and application for continuing and supplemental funds ($6.6 million and $1.2 million respectively) from the CDC for HIV prevention efforts, the continued use of the model in HIV prevention planning, and the ability to use the principles of the model as a basis for providing future technical assistance in community planning.     

Work stress and musculoskeletal disorder etiology: The relative roles of psychosocial and physical risk factors

The intense battles preceding the recent promulgation of OSHA's Ergonomics Program Standard serve as a case study demonstrating the growing understanding that MSD causation, development, and exacerbation are the result of the combined contribution of (and possibly interaction between) a wide range of biomechanical and psychosocial stressors. The best designed studies, those that adequately measure both biomechanical and psychosocial exposures, strongly support this hypothesis. Work stress is one of the results of this stressor combination and is part of the physiological pathway to MSDs and a wide range of other occupational diseases. Prevention efforts geared to a single or single class of exposure may be only partly effective, ineffective, or even counter productive. The most effective control strategies are rooted in on-going, participatory ergonomics programs, incorporating a joint labor/management ergonomic team; this blueprint for intervention necessarily addresses the roots of both physical and psychosocial work stress experienced by workers.     

Changing Directions in HIV Prevention: The Move Toward a Psychosocial Model

ABSTRACT

Although some HIV prevention programs have been successful in helping gay and bisexual men change their sexual behaviors, rates of HIV infection continue to increase. In an attempt to address this problem, social workers need to move beyond traditional HIV prevention approaches to a psychosocial model of HIV prevention. Based on the work of previous researchers, this approach assumes that a combination of individual, psychological, and social factors contribute to risky sex in gay and bisexual men. Because social workers are trained to view problems from a psychosocial framework, they are already in a position to develop programs incorporating the psychosocial model. This article examines the psychosocial model of HIV prevention and the various psychosocial factors that may contribute to high-risk sexual behavior and concludes with examples of prevention research that have already incorporated the model.     

Evidence-based exposure criteria for work-related musculoskeletal disorders as a tool to assess physical job demands

Despite worldwide attention, musculoskeletal disorders (MSDs) remain a substantial concern at work. To support ergonomists to assess the work-related risk factors for MSDs, several instruments are available. Unfortunately, many of these instruments are not supported by evidence-based exposure criteria for particular MSDs. For effective prevention of MSDs, it is important to know to what extent work-related risk factors are present in the work situation. The Netherlands Center for Occupational Diseases (NCOD) develops evidence-based criteria documents for the assessment of work-related MSDs. The exposure criteria of these documents can be used on a group level to support ergonomists in their assessment of the physical job demands that are associated with work-related MSDs. At the moment the NCOD has exposure criteria for the assessment of 22 work-related MSDs, for instance on the work-relatedness of upper extremity disorders, non-specific low back pain or patellar tendinopathy. The use of these exposure criteria enables ergonomist to better assess the work-related risks of MSDs as a starting point for effective prevention.     

The nature of working in the United States: an occupational therapy perspective

Although working is considered by occupational therapy practitioners to be an important life role, there is very little information about the nature of working in the occupational therapy literature. This article reviews the construct of working in three ways: 1) The history of working and how it has shaped the modern beliefs about working; 2) The nature of working; and 3) The health promoting attributes of working. The paper will also discuss research done on how working is viewed by individuals with disabilities and will touch on some of the implications of the cultural bias in the workplace toward workers with disabilities. Through this increased knowledge of the nature of working, occupational therapy practitioners and other vocational rehabilitation professionals will be better equipped to break down the subtle cultural barriers, and help individuals with disabilities to participate in working.     

Pilot project in developing community rehabilitation service for migrant workers suffering from pneumoconiosis in Mainland China

Pneumoconiosis is one of the major occupational health problems in China and increasing numbers of migrant workers suffered from this occupational disease after working in a dusty environment for few years. These migrant workers panicked after being diagnosed as suffering from pneumoconiosis and facing physiological disturbances including progressive dyspnea, respiratory failure or complications like silico-tuberculosis after their return to their rural village. This article reviews the preliminary results of a community rehabilitation pilot project conducted in a rural village in Guizhou, one of the provinces in southwest China. It shares the joint effort of professionals from Guangdong Province and Hong Kong SAR on supporting the migrant workers to manage and cope with this occupational disease. Finally, strategies including early intervention were suggested to help migrant workers to manage the disease. Most importantly, occupational health promotion and prevention were urged as the measures of utmost importance in reducing the risk for migrant workers suffering from pneumoconiosis.     

The geriatric social worker and his self-awareness

Abstract

Hospice and palliative care services have become an established part of Australian health care in the last decade. Multi-disciplinary teams are usually a feature of such services and social workers are common members of such teams. Yet the exact extent of their use and role in these programs has not been investigated previously. The author conducted a survey of 53 social workers working in such programs and at the same time, another questionnaire was also sent to service directors in all 134 Australian programs about their utilisation and perception of social workers. This article reports the results of both surveys. The results show that a third of the programs employed social workers, but the social workers themselves reported a number of difficulties: nurses are often the dominant occupational group and role-blurring amongst team members is common. The findings are discussed in terms of their implications for the social work profession.     

Mitigation of musculoskeletal problems and body discomfort of agricultural workers through educational intervention

Farming is a physically arduous occupation that places farm workers' at potential risk of musculoskeletal disorders, which has been observed to impose a greater impact on their health. Each activity in agriculture brings about certain stress and strain on bones and muscles leading to work-related musculoskeletal disorders which can lead to several permanent diseases and disabilities. The purpose of analyzing musculoskeletal problems among male and female workers engaged in agriculture was to know about the risk factors dangerous to health so that interventions can be planned for mitigating them thereby increasing the efficiency of work. Educational intervention included audio-visual aids as well as printed literature. It was hoped that awareness of these factors through dissemination of information would contribute at preventing hazards amongst farmers and their families. The results revealed that the workers reported very severe to severe pain in low back while performing agricultural activities. Weeding was the most strenuous activity for females and threshing crop for males. Training and education on MSDs through educational intervention proved that the knowledge of the farm workers could be enhanced and can help reduce risk of many musculoskeletal problems. It can be help in empowering the community and mitigate MSDs in agriculture.     

Improving work programs' delivery of information and service to workers' compensation carriers

This paper presents the results of a telephone survey of workers' compensation carriers, addressing how occupational therapy work programs can best meet these carriers' needs. Fifty percent of the market share of workers' compensation carriers in Michigan participated in the survey. Survey results indicated that workers' compensation carriers found Functional Capacity Evaluations, job analyses, and work hardening to be important work rehabilitation services. A significant portion of the respondents (88%) stated that they recognized the need for clinically successful work rehabilitation programs and indicated that if they had return to work rates for different providers, they would utilize providers that had the most successful outcome data in a specific geographical area. Occupational therapists can use these survey results to improve their services and communication with insurance to ensure that injured workers will continue to have access to the efficacious interventions occupational therapists provide in work rehabilitation.     

Study and analysis of occupational risk factors for ergonomic design of construction worksystems

Manual material handling (MMH) is unavoidable because of the nature of jobs or tasks as and man-machine interfaces in a construction worksystem. Data were collected from six strata of workers viz., masons, mason helpers, carpenters, welders, gas cutters and ground-level helpers (259 out of 700 workers) from a construction site of a steel plant located in India to analyze different types of occupational risk factors, such as awkward posture, repetitive movements and others associated with MMH activities to assess their impact on musculoskeletal disorders (MSDs). It is essential that these risk factors are required to be under control through application of ergonomics-based design approaches for construction worksystem. In this context, multinomial logistic regression analyses were used to identify the significant risk factors among the workers. The results shows that masons, mason helpers, carpenters, welders/gas cutters and ground-level helpers are greatly affected by static body posture, type of tools used, excessive stress due to repetition, awkward postures and extreme climate, respectively. Appropriate preventive and corrective measures are suggested for minimization of risks associated with such jobs/tasks to improve health and performance of the workers.     

The effectiveness of intervention strategies used to educate clients about prevention of upper extremity cumulative trauma disorders

The increased prevalence of work-related cumulative trauma disorders (CTDs) of the upper extremity highlights the need for effective prevention programs. This paper examines the effectiveness of different intervention strategies used to educate workers about the prevention of upper extremity CTDs. The articles reviewed include primary prevention and reinjury prevention interventions in both clinical and workplace settings. The current research findings are inconclusive. Intervention strategies may include discussion, demonstration, or practice of proper posture and body mechanics. Practice of correct techniques may not be necessary to achieve improved hand-use patterns in assembly-line workers. However, practice with intensive feedback may be necessary to achieve the best performance of hand-wrist position, but not sitting posture, in computer operators. The effects of practice on correct hand use may depend on the type of job task. Further research is needed to clarify the role of practice and feedback in CTD prevention.     

Autism,employment, and the role of occupational therapy

The purpose of this article is to review the existing literature to generate guidelines for the role of occupational therapy in employment for persons with autism. Previous research about strengths and barriers to employment, and types of employment commonly offered to persons with autism are reviewed. The supported employment model is identified as the most productive approach for use with this population. The four approaches to the supported employment model and the best practice contributions of several innovative supported employment programs are discussed. The interdisciplinary team approach is best to assist persons with autism to gain employment and ensure success on the job. The role of the occupational therapist as a beneficial team member in assessment, job development, job placement and training, and supported employment is outlined.     

Preventing workplace aggression and violence--a role for occupational therapy

Workplace aggression and violence is the fastest growing societal concerns in USA. The review of literature indicates that violence is a substantial contributor to occupational injuries and death. Preventative strategies for minimizing the risk of workplace violence include, cash-handling policies, physical separation of workers from customers, environmental modifications; good lighting, security devices, escort services, and employee training. Studies also suggest that as a preventive measure, employers will attract and retain the best workers if high-risk behaviors are discouraged and appropriate behaviors are supported. Proactive strategies reduce stress, increase productivity, and enhance creativity. A role for occupational therapy practitioners in the prevention of workplace violence is proposed.     

Consulting in industry: Moving beyond traditional interventions

Despite increased efforts to address musculoskeletal disorders (MSDs) in the work place, these injuries continue significantly impact the bottom line financial performance of companies, not to mention the health and safety of their most important resource - their workers. As MSD costs continue to rise, rehabilitation professionals must approach effective injury management and prevention processes from an onsite perspective. A paradigm shift is in order. Successful practitioners need to transform themselves from a clinical specialist to an onsite consultant. This article introduces various elements that are critical to the successful transformation of an onsite consultant. Effective onsite injury management and prevention concepts are discussed. Case studies are also presented to further illustrate the value of the onsite consultant approach.     

A return to work program for injured workers: a reassignment model

The current workers' compensation system does not encourage permanently restricted workers who are disabled due to work related injuries to return to work. Workers are often labeled permanently disabled and are released from their positions with their employers. However, according to the Americans with Disabilities Act of 1990, these individuals may be qualified to return to productive employment. This paper will describe a Reassignment Model for occupational therapy supported by the rehabilitation frame of reference. This Model presents reassignment to a vacant position as a reasonable accommodation to return injured workers to productive employment. A case study will illustrate the successful implementation of the model. The potential benefits of using this Model will be described for clients, society, employers, and the occupational therapy profession.     

Target groups for prevention of neck/shoulder and low back disorders: an exploratory cluster analysis of working and living conditions

Musculoskeletal disorders (MSDs) have a multifactorial etiology. Therefore, a holistic approach to identifying target groups for primary/secondary prevention is essential. In this study, an exploratory person-oriented approach was applied, using cluster analysis of variables related to physical and psychosocial work conditions, and conditions in the private sphere, on a data set of 1,341 Swedish women and men who had not sought care for MSDs the 6 months preceding enrollment in the study. Three groups at risk and five "healthy" groups regarding MSDs were identified. Two of the risk groups had a strained situation regarding psychosocial work conditions or domestic/family conditions, respectively. The majority of individuals in these groups were women. The third risk group had a strained situation regarding both physical and psychosocial work conditions. This group consisted largely of men working in male-dominated jobs. The five healthy groups had low/moderate metabolic demands at work, and all of them having high proportions of subjects with moderate to high education, and fairly even distributions of men and women. In conclusion, the results indicate that gender-specific working and living conditions are associated with an increased risk for MSDs. The identification of these subgroups in the population may facilitate a selective prevention approach.     

Work rehabilitation for migrant workers with work injury--the magic of Chinese paper cutting

As China has gradually transformed from agricultural economy into industrial economy since 1978, occupational injuries and diseases become a serious social problem in China. For occupational rehabilitation professionals, helping workers with occupational injuries and diseases, return to work and re-integrate to community are the ultimate goals of occupational rehabilitation. This article reports a new indigenous initiative with cultural notions in occupational rehabilitation piloted by Guangdong Provincial Rehabilitation Center. Case studies reflected that by learning and practicing traditional Chinese paper cutting, workers with occupational injury and disease could regain their self confidence, identity their strengths, learn more vocational skills as well as to re-integrate into community.