A criterion-referenced multidimensional job-related model prediction capability to perform occupations among persons with chronic pain

OBJECTIVE: The purpose of this prospective study was an exploration of the construct of the criterion-referenced multidimensional job-related model (CMVA) aimed for predicting patients' with chronic pain capability to perform occupations. METHODS: The study samples were 1) participants (n=84) who at present were not performing employed work (median sick-listing period 12 months) because of chronic pain and 2) participants (n = 104) who at present were performing employed work at least 20 hours of a workweek. The participants had experiences of 40 different occupations classified into five of the occupational categories of Jist's Enhanced Dictionary of Occupational Titles. Data were collected through ten assessment instruments and a structured interview, comprising 54 variables and 465 items. Data were analyzed using multiple regression with forward entering of variables. RESULTS: The CMVA model (Adjusted R^2 0.777, F (4, 183) = 164.067; p<0.001) was able to explain 78% of the variance. CMVA contained the aspects; "the work demands-variable, the person-variable of work life values, the environment-variable of social support and the two occupational performances-variables; self-perceived capability to perform work tasks/the simulated work tasks". CONCLUSIONS: The construct of CMVA was robust suggesting that among persons with chronic pain, the predictors focusing on their capability to perform occupations are of great importance.     

The sense-of-coherence and the capability of performing daily occupations in persons with chronic pain

OBJECTIVES: It may be helpful for occupational therapists who promote enabling occupations among persons with chronic pain, to understand the relationship between the persons feelings of meaningfulness, comprehensibility and manageability in life and their capability to perform daily occupations. AIM: The aim of this study was to describe and investigate how these concepts of person and occupational performance of 27 daily occupations in terms of "effort", "inconvenience", "avoidance", "give up", "frequency" and "satisfaction" were related to each other. DESIGN: A prospective correlative study was conducted. METHOD: A consecutive series of eighty-four patients with chronic pain completed a structured interview and responded to the self-assessment instruments Sense-of-Coherence Scale (SOC-13) and Capability of Performing Daily Occupations (CPDO). RESULTS: Weak but significant correlation (p < 0.05) were found between the SOC-13 sub-scale "manageability" and the specific occupations "physical exercise / training" (r = - 0.24), "climb stairs" (r = - 0.27) "social activity" (r= - 0.25) and "wash the laundry" (r = - 0.30), as well as between the SOC-13 sub-scale "meaningfulness" and the CPDO occupations "grocery shopping" (r = -0.22), "performing meals" (r = - 0.24), and "wash the laundry" (r = - 0.31) and the CPDO question "frequency of performing occupations" r = -0.22). The participants' mean value (mean = 58) of SOC-13 was below the other populations represented in a literature review. The mean values for CPDO (3.4-4.3) (optimal score is zero) showed that the participants perceived themselves having activity limitations concerning performance of daily occupations, and the performance area of work productive activities were experienced as more disabling. The degree to which the participants perceived themselves having a strong sense of coherence or being disabled by pain varied greatly both for the results of SOC-13 ( range 32-90 points) and CPDO (range 1.1-7.8 points). CONCLUSION: The expected significant relationship between a person's sense of coherence and the performance of daily occupations was partly verified with weak significant correlations. In clinical practice the assessment instruments are suggested to be of value in rehabilitation clinics for occupational therapists who work with people with chronic pain.     

Therapeutic Return to Work: Rehabilitation in the workplace

Therapeutic Return to Work is a work rehabilitation program linking graded work exposure with functional restoration therapy for chronic low back pain. This study evaluates the impact of the program on stable return to work (RTW) and compares it with the impact on RTW of three frequently used ways of management of back pain (normative comparison). At two year follow-up, 93% of participants of the Therapeutic Return to Work program were working. This rate was higher than in the comparison groups. Although limited by its norm-referenced evaluation design, the results of this study indicate the importance of placing the work site in the center of the of work rehabilitation process. In this program occupational therapists make full use of the client's natural environment.     

Sociodemographic Determinants of Occupational Risks of Exposure to COVID‐19 in Canada

The activities performed by Canadian workers in some occupations may increase the risk of exposure to infectious diseases such as COVID‐19. This research note explores how occupational exposure risks vary by labor force characteristics using publicly available Canadian data in combination with a data set providing information on the level of physical proximity and frequency of exposure to infections or diseases faced by workers in different occupations. The results show important sociodemographic differences. First, women work in occupations associated with significantly higher average risks of exposure to COVID‐19 than men. This is driven by their overrepresentation in high‐risk broad occupational categories such as health occupations. Second, older workers (65 years or more), a group vulnerable to COVID‐19, appear to work in occupations requiring performing activities characterized by a lower level of physical proximity than their younger colleagues, with minimal differences in the frequency of exposure to diseases or infections. Finally, workers in low‐income occupations are employed in occupations that put them at greater risk of exposure to COVID‐19 than other workers. This is especially the case for women, immigrants, and members of visible minority groups in low‐income occupations. More broadly, this research note provides insights into the health‐related dimension of the literature on occupational tasks and labor market stratification.     

Validation of the theory: satisfaction with time-delimited daily occupations

OBJECTIVES: This study examines the construct validity of the theory Satisfaction with time-delimited daily occupations (STO). The outcome of STO concerns how individuals perceive their occupational health status and to what degree the individuals experience satisfaction with their performance of time-delimited daily occupations. DESIGN: The "known-groups technique" was used for discriminating the occupational health status among four groups (n = 147) of full-time workers or sick-listed participants. A mailed ActivityLog-sheet was used for recording their occupational health 24 times during 24 hours. The computerized program ActivityLog was used for data registration. The data analysis were accounted by ANOVA, Tukey's HSD test with significance level of p < 0,05 using the SPSS program. RESULTS: The occupational health status did not differ significantly among the four groups, but the number of records concerning work (p = 0,00) and care (p = 0,02) time-delimited daily occupations were significantly different. The patterns of occupational health status during the 24-hour-records were visually separated for the four groups. CONCLUSION: There is need for refining the STO theory and then for undertaking further investigations of the STO construct validity.     

Part I. Work hardening for warriors: Occupational therapy for combat stress casualties

Combat stress is an occupational hazard of the military. Soldiers who become job-ineffective due to combat stress are termed "battle-fatigued." Occupational therapy, in the form of work hardening, is an important part of the management of these soldiers. Occupational therapists possess specialized knowledge and skills which make them uniquely qualified for this role. These assets include knowledge of neuromuscular and psychosocial aspects of occupational performance; the ability to do task analyses; the ability to assess occupational performance deficits; the ability to synthesize appropriate therapeutic occupations to rehabilitate functional deficits and match these to the needs of dysfunctional soldiers. These same resources serve occupational therapists equally well in civilian work hardening settings. This paper reviews the management of combat stress casualties, describes the Army units which minimize the impact of combat stress reactions, and delineates the Army occupational therapists' roles of soldier, mental health practitioner, and work hardening coordinator.     

AWARD WINNING PAPER: 1987 ALPHA KAPPA DELTA UNDERGRADUATE STUDENT PAPER COMPETITION Women in Traditionally Male Occupations: An Exploratoy Model of Gender-Work Assimilation

A model of gender-work assimilation is employed to evaluate the structure of male-dominated occupations and the behavior of women employed in these occupations. It is suggested that because certain occupations have been the exclusive domain of males, the masculine sex-role "spilled-over" into the definition of job related tasks. The masculine sex role and work-emergent behavior cause women to act according to the norms of the occupation. With low occupational representation, women choose, or are pressured into choosing, job specialties considered sex appropriate. The author also suggests that the higher proportion of women in the occupation, the less conforming and more individualistic women become in choosing job specialties.     

An overview of work, retirement, and pensions in Japan

Work to retirement in Japan is a sequential transition for the most part, and Japan permits mandatory retirement by firms at age 60. But many older people work beyond the age of 60, many more than in other industrialized countries. A number of hypotheses are examined, having to do with pensions, health, opportunity, interest in working, cultural attitudes (including the concept of ikigai), and public policy initiatives (such as employment policy and the Silver Human Resource Centers). Japan's cultural attitudes and existing policies appear to have set Japan on a unique course in considering the aging of its population. To what extent should other nations emulate Japan?     

Case report: a work simulation program for a manual worker with a fracture injury

Work rehabilitation programs targeting different client groups are available in nearly all major hospital occupational therapy departments in Hong Kong. Clients receiving work rehabilitation are referred from various out-patient clinics and other occupational therapists. Those clients experience limitation in work after their injuries or diseases and plan to return to work after rehabilitation. Program objectives are 1) to assist clients to reach maximum work capacity as rapidly as possible 2) to ensure clients return to work safely 3) to improve clients' work readiness. This case report describes an individualized work simulation program at a general hospital in Hong Kong provided for a typical client who is preparing to return to his worker role. Specific job analysis, goals and program rationale for the client are discussed.     

Theoretical Trends in the Sociology of Occupations*

In order to determine the directions which the field of sociology of occupations has taken in recent years, a content analysis of articles on work and occupations in four general sociological journals and two specialized journals was completed for the years of 1976 to early 1982. Not surprisingly, there has been a rapid increase in the number of papers dealing with status and income attainment. Very surprisingly, there has been a near demise of papers en the professions. Another dominant trust has been the large number of articles on women and sex roles. Satisfaction and alienation at work and attempts at job redesign have also received increasing attention. Papers on other topics have received less concentrated attention. Moving beyond the results of the content analysis, the present work discusses unresolved theoretical issues and potential new directions for the content areas. It is suggested that even for sociologists who do not identify themselves as specialists in occupations, the occupational variable remains a dominant one in sociological analyses.     

An Overview of Work,Retirement, and Pensions in Japan

Work to retirement in Japan is a sequential transition for the most part, and Japan permits mandatory retirement by firms at age 60. But many older people work beyond the age of 60, many more than in other industrialized countries. A number of hypotheses are examined, having to do with pensions, health, opportunity, interest in working, cultural attitudes (including the concept of ikigai), and public policy initiatives (such as employment policy and the Silver Human Resource Centers). Japan's cultural attitudes and existing policies appear to have set Japan on a unique course in considering the aging of its population. To what extent should other nations emulate Japan?     

Do Female Colleagues and Supervisors Influence Family Role Attitudes? A Three‐Level Test of Exposure Explanations Among Employed Men and Women in 27 European Countries

This study examines the relationship between various aspects of female labor participation and people's family role attitudes. Following exposure theory, we expect that individuals may adopt more egalitarian family roles as they are more often exposed to employed women because it dispels negative ideas about women's capabilities and brings them into contact with nontraditional networks. This study provides an elaborate test by examining the role of exposure to female colleagues and supervisors in three contexts: workplaces, occupational sectors, and countries. We found that the number of female colleagues at work and in occupational sectors was positively related to egalitarian family roles of employed men. Our study further showed that this positive relationship between exposure to female colleagues at work and men's egalitarian family roles was weaker in female‐dominated sectors. Remarkably, exposure to national female labor participation was not significantly related to the family roles of employed women.     

I'm going back to work: back injured clients' perceptions and experiences of their worker roles

This study aimed to elicit perceptions and experiences of facilitators and barriers that affected individuals who received back rehabilitation and their ability to resume their worker roles. Qualitative research methods were used in order to explore the research question. Participants were selected by means of simple random sampling and the data were collected by means of semi-structured focus groups. Some factors that were seen as facilitatory in maintaining the worker role of an individual who received back rehabilitation included injury management strategies, a positive work culture and having meaningful/satisfactory work experiences. Factors or barriers that prevented individuals from resuming their worker roles included physical and psychosocial stressors of the job, a lack of education by the employer and inadequate workplace policy. The results indicated that occupational therapists need to reassess their role within the wider context of the helping professions where they should become more involved in on-the-job evaluations, work placements and training of individuals who received back rehabilitation.     

ABOUT THE AUTHORS

Work satisfaction, self‐esteem, and alienation measures were obtained from white males in three service occupations (bartenders, barbers, and mailmen) at different levels of the occupational prestige hierarchy. While we found an overall positive relationship between work satisfaction and occupational prestige, this only held for variables where societal reference groups were forced upon the respondents. Such findings suggest that the relationship between work satisfaction and occupational prestige is less absolute than usually suggested by the literature. Hypotheses from the literature arguing for a direct relationship between occupational prestige and alienation were not supported by our data. We conclude that sociologists probably overestimate the salience of work and occupational prestige for the working class.     

Construct validity of the instrument DOA: a dialogue about ability related to work

This study examined the construct validity of the newly developed instrument A Dialogue About Ability Related To Work (DOA). DOA [18] was developed using concepts from the Model of Human Occupation [20] as theoretical framework. The instrument assumes the assessment of work ability by both the client and the occupational therapist, and is followed by a dialogue which is expected to distinguish possible goal-setting for further rehabilitation [18,19]. Twenty-one professionals and 126 clients from three clinics in Sweden participated in the study. All clients were involved as outpatients in psychiatric work rehabilitation in county councils or community services. Results of a Rasch analysis test indicated that items are well separated and generally work together in five unidimensional continuums to measure work ability. Twenty-nine of 34 items showed goodness-of-fit statistics, which means acceptable infit MnSq values from > or = 0.6 to < or = 1.4 in association with Z values from -2 to 2. The five misfit items have to be revised. The study has indicated that DOA is a valid instrument in psychiatric work rehabilitation and ought to be useful in the dialogue between occupational therapists and clients about goalsetting and treatment planning.     

Impairments and perceived competence in persons living with HIV/AIDS

Medical advances have transformed HIV/AIDS from a short-term terminal illness to a long-term chronic condition. Consequently, the disability experience of persons with HIV illness has shifted from issues related to physical well-being to those concerning performance of daily life activities and wider community participation. These changes have necessitated rehabilitation interventions for persons with HIV/AIDS to focus on issues related to enabling participation in all spheres of everyday activities. However, limited information is available on the impairments prevalent in the emergent population of people living with HIV/AIDS and on the impact of these impairments on the person's functional performance and participation in various occupations of daily living. The present study attempted to explore these issues as they are experienced by the emergent population of people living with HIV/AIDS. The purpose of the study was: (1) to explore occupational functioning across various activities, (2) to describe the various impairments prevalent in this population, and (3) to examine the impact of these impairments on the person's perceived occupational competence. Two instruments, the Sign and symptom checklist for persons with HIV disease and the Occupational Self-Assessment were administered to a sample of 35 individuals (Mean age=42.8 yrs.) living in supportive living facilities. Impairments most commonly identified by the participants included: fatigue; fear/worries; difficulty concentrating; muscle aches; and depression. The two primary areas of occupational functioning where participants reported experiencing moderate to severe difficulty included: managing finances and physically engaging in activities which were reported by 67.7% and 35.5% of the participants respectively. No statistically significant correlation was observed between various measures of impairments and the overall measure of perceived occupational competence for the sample of individuals living with HIV/AIDS included in this study.     

Technological knowledge,curriculum and occupational role potential*

This paper examines technological curricula in terms of their potential to be realized in occupational roles. The more the curriculum is oriented towards roles (as opposed to skills or pure knowledge), the greater the probability that it will be articulated in the labour market and the greater its efficacy and legitimacy. The concept of role has been analytically divided into six components: value commitment, normative, communicative, interactive, role intelligence and proficiency components. Theoretically, the more components are present in a given curriculum, the higher the probability that a given occupational role will be effectively articulated. However, their presence is a necessary but insufficient condition for effective role performance; their integration is of equal, if not greater importance, and the latter is meaningful only when the social context of the articulation is taken into account. It was found that the role components do not appear in a balanced manner in technological curricula investigated in Israel, and some hardly receive any attention. Those that are present are weakly linked to actual economic contexts. Thus, it appears that students in technological education, are socialized to minimal role articulation; ie, they are more likely to implement decontextualized tasks than to assume integral occupational roles.     

Well-being and occupational roles among middle-aged women

One purpose of the present study is to explore the stability of the pattern of health/work and sickness absence among middle-aged women over a period of three years. This study tested two hypotheses: (a) that enduringly healthy working women would perceive more valued occupational roles and higher well-being than long-term sick-listed women; (b) that high levels of well-being at baseline would predict enduring health and occupational role value at a 3-year follow-up. Middle-aged women (n = 208) answered a postal survey with the Role checklist, a well-being scale and questions about work and sickness situation. The results showed that there was a considerable variability in the pattern of health/work and sickness absence. The variability was greatest among the women who were long-term sick-listed at baseline, and the internal drop out was great among them. The results showed that the enduringly healthy women experienced a more valued worker role and higher well-being than the long-term sick-listed women. Furthermore, high levels of well-being concerning health and work predicted enduring health in the studied sample, and high well-being concerning work was predictive of a valued worker role. Interventions that enable women to develop valuable worker and leisure roles, as well as harmony between different roles, may be important constituents of health promotion/rehabilitation programmes.