Work hardening: Outdated fad or effective intervention?

OBJECTIVES: The purpose of this outcome measurement study was to determine the effectiveness of a work hardening program as measured by the participants' work status at three months after program completion. Predictors of successful return to work were explored. STUDY DESIGN: The sequential case series design was employed, and data were gathered at three points: the initial work hardening assessment, the discharge assessment, and three months post-discharge from the work hardening program. Seventy-nine participants were included. RESULTS: Eighty-two percent (82%) of the clients who completed a work hardening program reported that they were working in some capacity three months after program completion. They listed their employment status in 5 sub-categories. Significant predictors of employment included "single" marital status, lower perceived disability scores at program entry, reduction in reported pain during program duration, and funding source. CONCLUSION: Work hardening remains an effective treatment strategy which promotes successful return to the workplace. Ongoing analyses of these programs is imperative.     

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.     

Managing Work and Family: The Decision to Outsource Child Care in Families Engaged in Family-Owned Businesses

This study investigates the decision to outsource child care among families involved in family-owned businesses. A management framework is used to examine the impact of inputs to the decision (i.e., goals and resources) and level of management activity (i.e., planning and implementing) in these families as predictors of the choice to outsource child care. The data are a sub-sample of the data from a project entitled, Family Businesses: Interaction in Work and Family Spheres (Winter, Fitzgerald, Heck, Haynes, & Danes, 1998) undertaken in 1997. Study findings indicate that household managers who work in the family business are less likely to outsource child care compared to those who work outside the family business. More educated household managers purchased more, and managers in larger families fewer hours of child care. Female household managers purchased significantly fewer hours of child care compared to their male counterparts.     

Perception differences between groups of employees identifying the factors that influence a return to work after a work-related musculoskeletal injury

Employee health and productivity losses as a result of work-related injury are estimated to be US dollars 1.2 trillion annually to US companies. This is approximately 14.3% of the gross domestic product [6,8,11,35]. Workers' compensation, medical care, and short and long-term disability are a part of these costs. Controlling or eliminating these costs is a problem for US employers [3,6,14,21,29]. The study discussed in this article examined the perceptions of manufacturing employees in identifying factors that influence a return to work after a work-related musculoskeletal injury. The classification of employees who participated in this study were safety professionals, supervisors and workers from the manufacturing industry in central Kentucky. The worker group consisted of material handlers, assembly line workers and quality control inspectors. The participants completed a developed survey instrument, the Return to Work Perception Survey. This survey instrument examined the perception of the participants on factors related to return to work: company policies and procedures, job satisfaction, worker relationships and work environment. The results indicated safety professionals and supervisors perceptions differ from workers on the variables of job satisfaction, worker relationships and work environment. Their perceptions did not differ on the variable relating to company policies and procedures. In addition, the safety professional and supervisor groups rated the items addressing job satisfaction higher than did the worker group. The worker group did not differ from one another on any of the factors. Implications of this study for manufacturing companies suggest (a). identifying those issues contributing to employee job satisfaction, (b). developing a plan for achieving increased job satisfaction and employee recognition at the workplace among all workers, and (c). consider allowing employees to develop new capacities and new learning, thus fostering motivation and job satisfaction [18,20].     

Work injury rehabilitation in Guangzhou: 380 case cohort study

Work injury rehabilitation is a new concept in Mainland China. In 2001, the first work injury rehabilitation centre was established in Guangzhou under the management of the Guanghzhou Bureau of Labour and Security. This paper reviews the profile of a cohort of workers with injuries who received rehabilitation services at this centre. The changes in the physical capacity, daily function, and quality of life of the workers with injuries before and after the treatment services were also reviewed. A total of 380 were extracted from the database which occupied 79% of the total patient population admitted to the centre between 2003 to 2004. The assessment results suggested that workers with injuries showed increases in physical capacity in terms of the range of motion, muscle strength and walking tolerance. The daily functioning by using Barthel Index was also improved. Quality of life assessed with the WHOQOL also demonstrated an increase in the physical and psychological domains. Work injury rehabilitation in Guangzhou is at its infancy stage. The cooperation between the rehabilitation centre, employers and workers is of the utmost importance for a successful return to work outcome. The workers' compensation and rehabilitation policy also dictates the future of success of the rehabilitation services.     

Assessing child care need under welfare reform

Suggestions for improvements to this research by Sherrill Friedman, Paula Brush and Subhash Sonnad are gratefully acknowledged.

With the advent of welfare reform, recipients of Aid to Families with Dependent Children (AFDC) are now required to enter the workforce. This workforce entry brings the need for child care. Two problems concerning child care emerge: poor women participating in the workforce at entry level jobs often require child care during hours when care is not readily available (Miranne & Young, 1998); and welfare reform s work requirement will necessitate a predicted ten percent increase in child care services (Maynard, 1989), while only a four percent increase in funding for child care is being mandated by the federal government (Blank, 1997). This essay explores welfare reform and its effect on child care availability by demonstrating its impact at a local level.     

Mothers in the workforce

This evaluation of maternity leave was completed by the Australian Institute of Family Studies. The use of maternity leave was investigated in 3 separate surveys. In 1, all women throughout Australia who had borne a child during 1 week in May 1984 (2000 women) were surveyed 18 months after the birth. The 2nd and 3rd surveys examined the experience of maternity leave in 1252 private sector businesses of varying sizes and a smaller number of public sector organizations. The study found that 46% of women are in the workforce during pregnancy. However, looking only at women in employment before the 1st birth, 3/4 of them are in the workforce. 44% of women took maternity leave, 33% were eligible but did not take leave, and the remaining 24% were ineligible for maternity leave either because they were casual workers or because they had not been in continuous employment with their employer for the required minimum period of 12 months. Of all maternity leave taken, 78% is taken by public sector employees and only 21% by women employed in the private sector. 1/2 of the women eligible for maternity leave in the private sector who did not take up the option had no information about maternity leave provisions. The main determinants of taking maternity leave, apart from having information about it, are working in the public sector, having a strong attachment to the workforce, having values which see work and child rearing as complementary, being a member of a trade union, having a high education and high status occupation, and being employed in a large establishment. Other survey findings follow. 1) 55% of women who were in employment before their 1st child returned to the workforce within 18 months of the birth. 2) 45% of women returned to work used informal child care provided by family or friends (usually unpaid). 32% used formal care only. 23% used a combination of formal and informal child care. 3) Women are spending an average of between 20% and 25% of their income on child care. 4) Financial reasons are the main reasons given by women for their return to the workforce. 5) Cost and availability of child care is an important issue in determining women's workforce participation after the birth of a child. 6) 60% of women do not return to the workforce after childbirth; 90% of these women intend to do so in the future. 7) For the majority of women who give birth, motherhood emerges as their most important role in life. Almost 1/2 the women agree that a woman should give up her job if it inconveniences her husband and children. 8) 2/3 of working women can establish just as warm and secure a relationship as non-working mothers, compared with 4 out of 10 non-working mothers.     

Writing diversity: Ethnicity and race in Australian Social Work, 1947-1997

Abstract

In 1997, Australian Social Work celebrated 50 years of publication. This paper provides a content and discourse analysis of 50 years of articles on Indigenous and immigrant Australians in the journal and its predecessors. The analysis critically evaluates the published accounts of cross-cultural social work research, policy and practice and identifies the meanings these articles convey of race and ethnicity in Australian professional identity and practice. The analysis found little published analysis of social work practice with Indigenous Australians and that articles written about Indigenous Australians are either more negative or more positive than the generally approving tone of articles about immigrants. Only one or two articles in either category proposed a structural or community development approach to practice.

An early draft of this paper was given at the AASWWE Conference, Cairns, 1998.     

Understanding churn: Predictors of reentry among families who leave the child care subsidy program in Maryland

Child care subsidies provide an important work support for low-income families, yet children often receive subsidies for only a short period of time and may cycle on and off the program. Much of the research to date on patterns of subsidy participation has focused on the duration of participation, and less attention has been paid to the dynamics of how often and how quickly children return to the program. This paper uses administrative data from Maryland to analyze the patterns of returns to the subsidy program after a break in subsidized care. We find that half of children who exited the program return to subsidy within five years, and most of those return within a few months. Returns to subsidized care are related to family circumstances, type of care, child age, and program policies related to eligibility redetermination. These factors have differential effects on the probability of returning to the same provider or a different provider, which may have important implications for the stability of children's care.     

"I'm still swimming"

Treatment of bipolar affective disorder is often difficult and lengthy. Enabling participation in a return to work process is equally daunting, primarily due to the dramatic and oftentimes sudden shifts in mood and thought. The following case study attempts to illustrate the complicated process of return to [and stay at] work for an individual who has mixed bipolar affective disorder. Work has always played a significant role in Ray's life and remains a valued goal and accomplishment for Ray. Work has been a means to structure and routine, and it has been from this routine that wellness has become possible for Ray. The metaphor, "I'm still swimming" helps to illustrate the continual treading of water, which both Ray and his occupational therapist [first author] have experienced over the past 6 years. This case study illustrates the strategies employed in maximizing the person-environment-occupation fit for Ray, as well as the importance of collaboration and partnership in the return-to-work process. It is also meant to stimulate thought and discussion about what is important for occupational therapists, and other health professionals to consider, when attempting the task of return-to-work for an individual with mixed bipolar affective disorder.     

Online Teaching in Social Work Education: Understanding the Challenges

There is a rapidly growing industry of online learning and distance education programs at the Master of Social Work and Bachelor of Social Work levels both within Australia and globally. A number of best practices have emerged from the literature that warrant consideration when delivering social work programs in online learning and distance education modes. Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education, including limited financial resources. Social work academics need to become aware and implement best practices in online learning and distance education e-teaching environments to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings. The purpose of this paper is to identify and discuss the challenges and benefits of distance education and online learning for consideration when providing a social work program in these delivery models.

IMPLICATIONS

• Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education.

• Social work academics need to become aware and implement best practices in the distance education and online teaching environment to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings.

     

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.     

Sources of health insurance and characteristics of the uninsured: analysis of the March 1999 Current Population Survey

This Issue Brief provides summary data on the insured and uninsured populations in the nation and in each state. It discusses the characteristics most closely related to an individual's health insurance status. Based on EBRI estimates from the March 1999 Current Population Survey (CPS), it represents 1998 data--the most recent data available. In 1998, 194.7 million nonelderly Americans--81.6 percent--had some form of health insurance. More than 64 percent had it through an employment-based health plan; 6.5 percent purchased it on their own; and 14.3 percent were covered by a public program, mostly through Medicaid (10.4 percent). In 1998, 18.4 percent of the nonelderly population was uninsured (43.9 million people), compared with 14.8 percent in 1987. The percentage of uninsured Americans has generally been increasing since at least 1987, although the percentage uninsured in 1998 was not statistically different from the percentage uninsured in 1997 (18.3 percent). The increase in the uninsured prior to 1993 can be attributed to the erosion of employment-based health insurance. However, since 1993, the percentage of nonelderly Americans covered by an employment-based health plan has increased from 63.5 percent to 64.9 percent. The decline in public sources of health insurance would mostly explain the recent increase in the uninsured. For example, between 1994 and 1998 the percentage of nonelderly Americans covered by CHAMPUS/CHAMPVA declined from 3.8 percent to 2.9 percent, in large part due to downsizing in the military. Similarly, between 1993 and 1998, the percentage of nonelderly Americans covered by Medicaid declined from 12.7 percent to 10.4 percent as people left welfare. The increase in employment-based coverage since 1994 was due mainly to a higher likelihood that children were covered by an employment-based health plan. Between 1994 and 1998, the percentage of children covered by an employment-based health plan increased from 58.1 percent to 60.2 percent. For adults, it increased less than one percentage point, from 66.1 percent to 66.9 percent. Adults started to realize gains in employment-based health insurance between 1997 and 1998. Between 1994 and 1997, the percentage of working adults with employment-based health insurance coverage held steady at roughly 72.3 percent. During this period, health care cost inflation was essentially nonexistent. However, between 1997 and 1998, the percentage of working adults with employment-based health insurance increased from 72.2 percent to 72.8 percent, despite the apparent return of health care cost inflation in 1998. It is likely that the changing composition of the labor force accounted for some of the increase in employment-based coverage.     

Book Reviews

Jobs, technology and people N. Chmiel London: Routledge, 1998

Trends in organizational behaviour, (Vol 4) C.L. Cooper D.H. Rousseau (Eds) Chichester: Wiley, 1997

Work, leisure and well-being J. Haworth London: Routledge, 1997     

Recruitment and Retention of Latinos in Social Work Education: Building on Students’ Community Cultural Wealth

Spanish-speaking and culturally sensitive social workers are in high demand throughout the country to work with Latino clients. Latinos currently represent about 11% of active social workers, limiting the capacity of social work to effectively address the needs of the Latino population. Despite this shortage, little attention has been paid to the recruitment and retention of Latinos in social work. This article presents a case study that examines a BSW program accredited by the Council on Social Work Education, at a bilingual, private college where 90% of students self-identify as Latinos. It details how the BSW program builds on the students’ community cultural wealth to ensure continued recruitment and retention of Latino students. Implications for social work education are discussed.     

Teaching Note—Asserting Social Work’s Role in Developing an Interprofessional Education Project

ABSTRACT

Interprofessional (IP) education is an essential component of today’s health care education. IP education has been recognized and supported for its potential to educate workforce-ready health care clinicians with the knowledge and skills, necessary to collaboratively deliver high-quality, client-centered care. While social work’s reflective, patient-centered, and holistic approach to care is invaluable in addressing healthcare challenges at all levels, social work’s lack of involvement in IP health care team practice is evident in the development of IP education curriculum with other health care disciplines. This article describes how one School of Social Work at a regional public university became part of a longitudinal IP education project in collaboration with a large R-1 research university, creating an IP opportunity for Master’s in Social Work (MSW) students. It also discusses the process taken for social work inclusion in the IP project, an experiential elective course designed to supplement the project, as well as Transformative Learning Theory, the conceptual framework used.     

Predictive validity of a functional capacity evaluation: the physical work performance evaluation

The predictive validity of a Functional Capacity Evaluation, the Physical Work Performance Evaluation (PWPE), was examined in 30 workers compensation patients with musculoskeletal dysfunction who participated in an industrial rehabilitation program. Return-to-work recommendations were made by comparing the discharge PWPE to the physical requirements of the job. Kappa coefficients were used to compare PWPE recommendations to actual work at discharge, 3 months and 6 months. Substantial agreement was found between PWPE recommendations at all three follow-up points. This study provides preliminary evidence in support of the predictive validity of the PWPE for making return-to-work recommendations at the conclusion of an industrial rehabilitation program.     

Book reviews

Maurice Milliard and Simon Lee (eds.): The Politics of Social Policy in Europe. Cheltenham, Edward Elgar Publishing, 1997. 290 pp, ISBN 1-85898-367-3.

Jane Lewis (ed.): Lone Mothers in European Welfare Regimes: Shifting Policy Logics. London and Philadelphia, Jessica Kingsley Publishers, 1997. 214 pp., ISBN 1-85302 448-1 hbk; 1-85302 461-9 pbk.

Mlta Castle-Kanerova/ School of Policy Studies, Social Research & Politics, University of North London, UK

Saul Becker: Responding to Poverty. The Politics of Cash and Care. Social Policy in Britain Series. London, Longman, 1997. 223 pp., ISBN 0-582-24322X PPR.

Gunn Strand Hutchinson and Siv Oftedal: Modeller i sosialt arbeid: fra ulike retter til samme felt (Models in Social Work: From Different Roots to the Same Field). Tano-Aschehoug, Oslo, 1996. 265 pp., ISBN 82-518-3462-7, N.Kr. 268.00.

Michael Seltzer/ Faculty of Economics, Public Administration and Social Work, Oslo College, Norway

Malcolm Payne: Modern Social Work Theory (Second edition). Basingstoke, Macmillan, 1997. xiv+ 354 pp., ISBN 0-333-67654-8, £ 13.50.

Two roads diverged in a wood, and I -I took the one less travelled by, and that has made all the difference (Frost, 1916)

Martin Davies (ed.): The Blackwell Companion to Social Work. Oxford, Blackwell, 1997. 376 pp., ISBN 0-631-19876-8 (hbk), £50.00; 0-631-19877-6 (pbk), £14.99.

Steven Shardlow/ Director of Social Work Studies, Department of Sociological Studies, University of Sheffield, UK

Malfrid Grude Flekkoy and Natalie Hevener Kaufman: The Participation Rights of the Child: Rights and Responsibilities in Family and Society. London, Jessica Kingsley Publishers, 1997. 182 pp., ISBN 1-85302-490-2, £13.95.

Nigel Thomas/ Lecturer in Applied Social Studies, University of Wales Swansea

Adalbert Evers, Riita Haverinen, Kai Leischenring and Gerald Wistow (eds.): Developing Quality in Personal Social Services. Concepts, Cases and Comments. Aldershot, Ashgate, 1997. 312 pp., ISBN 1-84014-337-1.

John Harris/ Senior Lecturer in Applied Social Studies, University of Warwick, UK

Crescy Cannan and Chris Warren (eds.): Social Action with Children and Families. A Community Development Approach to Child and Family Welfare. London, Routledge, 1997. 218 pp. ISBN 0-415-13151-0.

Bert Jones/ North East Wales Institute of HE, Wrexham, North Wales, UK.     

Welfare Status and Child Care as Obstacles to Full-Time Work for Low-Income Mothers

SUMMARY

In this study, we use new data from the Philadelphia Survey of Child Care and Work to expand on previous analyses: we include child care problems as a work obstacle, and we analyze both current welfare recipients and non-welfare “working poor” mothers. Results show that two main obstacles have a large impact on full-time work: poor mental health and child care problems. Net of other factors, mothers with severe child care problems are 22 percent less likely to work full time. Dividing the sample by welfare status, we find a child care problems effect for both groups. Among welfare recipients, the gap in full-time work between those with severe child care problems and those without is 30 percent. Among the working poor, child care problems reduce the chance of full-time work by about 18 percent. Our findings show that improving mothers' child care situation can significantly improve their ability to support their families.     

Rates and correlates of recurrent psychiatric crisis episodes among children and adolescents in state custody

The purpose of this study was to determine the extent of and factors associated with recurrent psychiatric crisis episodes among children and adolescents in state custody. A total of 1362 children ages 3 to 16 years who were in custody of the child welfare agency and underwent a psychiatric crisis screening and services for the first time between 2001 and 2003 were followed for the same observation period of 24 months. Logistic regression was used to determine the clinical and non-clinical factors associated with a return to psychiatric crisis screening and services. Overall, 44.6% of the sample had another psychiatric crisis episode in the following two years. Nearly two thirds of those who returned did so within 6 months of their first crisis episode. A greater likelihood of recidivism was associated with severity of psychiatric illness, being female, white, in residential care placement, and having placement instability. Recurrent psychiatric crises appear to be predictable using readily available variables, which can inform interventions designed to reduce repeat episodes.