Work-related factors contributing to chronic disability in low back pain

Low back pain is a costly and incapacitating musculoskeletal disorder. Prospective studies documenting the capacity of work-related factors to predict chronicity are few in number, the methodology used is very diversified, and the results obtained diverge. The aim of the present study is to investigate the capacity of work-related objective (non-psychosocial) and psychosocial factors to predict chronic disability related to low back pain. A longitudinal prospective study with two measurement times was carried out. The sample (N = 258) consisted of workers with subacute low back pain who were on sick leave and receiving compensation from the CSST (Quebec Workers' Compensation Board). Of all the work-related variables measured, perceived stress and fears and beliefs about work were associated with return to work status at the six-month follow-up. The results obtained show the importance of considering fears and beliefs about work when identifying people in the subacute phase of low back pain who are at risk of developing chronic disability.     

Factors contributing to work related low back pain among personal care workers in old age

This study aims to preliminary explore the work related and individual factors that contributed to the occurrence of low back pain (LBP) that affected work activities of Personal Care Workers (PCWs). A cross-sectional study was conducted to 36 PCWs in an old age home of Hong Kong. The study is divided into three parts: 1) a questionnaire to document the workload exposure factors and the musculoskeletal symptoms survey of the PCWs, 2) work posture evaluation; and 3) an evaluation of the physical fitness and lifting capacity of the PCWs. Univariate analyses were used to explore the risk factors associated with LBP that affected work activities. The results indicated that individual physical profile and lifting capacities did not contribute to occurrence of low back pain at work. For the work demand factors, the perceived physical demands in lifting and lowering heavy objects, awkward sustain neck and back postures, loading on the back, and perceived effort of cleaning task contributed to the occurrence of LBP. For the physical environment factors, thermal stress and improper ventilation were associated with the occurrence of LBP cases. For the individual factor, LBP cases were associated with workers' self perceived muscular effort, and perceived risk of mental illness in response to work requirements.     

Interdisciplinary staff perceptions of an occupational therapy return to work program for people living with AIDS

The purpose of this qualitative study was to identify the perception of interdisciplinary staff members regarding the impact of a model work and independent living oriented program for residents in supportive living facilities. This study used focus groups and individual interviews to collect these perceptions. Staff members identified four areas of impact: utilization of a holistic and process-oriented approach, an ability to identify and work with the strengths of clients, emphasis on the learning of practical skills, and creating an intersection for all aspects of services. These findings point to the fact that staff members found the value that occupational therapy has to offer their overall programming by improving participation of clients with HIV in learning practical skills for use in their daily lives and in developing work related skills.     

A comparison of self-perceived physical and psycho-social worker profiles of people with direct work injury, chronic low back pain, and cumulative trauma

This study investigated the psycho-social factors among injured workers and the influence of their psycho-social profile on the readiness of return to work. Sixty-four subjects with injuries on the upper limbs or lower limbs, low back pain, or cumulative trauma disorder were recruited. The workers' profiles (self-perceived physical health, mental health, and work readiness) together with the impact and types of work injury on the workers' perceived wellness were measured. The regression model of work readiness was constructed to develop a theoretical background for predicting work readiness based on different factors. The results showed that injured workers with chronic injury such as low back pain or cumulative trauma had poorer self-perception of physical health and psycho-social/mental health compared to those with direct trauma. The regression analysis further affirmed that self-perceived pain and physical functioning were significant factors influencing the readiness for returning to work. Workers with low back pain were found to have lower motivation for returning to work. Other factors such as the non-verbal intelligence of the injured workers, their anxiety level, and the support they received from family members were found to have some indirect impact on their ability to return to work, but this was not statistically proven.     

Low back pain in physical therapists: a cultural approach to analysis and intervention

Low back pain is one of the most prevalent work related injuries in the physical therapy profession. New graduates and therapists working in rehabilitation and acute care hospitals are at the highest risk for developing low back pain [9]. Although physical therapists are trained in maintaining proper body mechanics and preventing work related injuries, between 30% and 63% of therapists will experience low back pain at some point in their careers [2,4,9]. The culture of physical therapy is one of the primary factors contributing to this problem, with many therapists reporting that their decision to use back pain preventive strategies depends on their colleagues' use of these strategies. The authors will use Green and Kreuter's PRECEDE-PROCEED model to identify behavioral, environmental, educational and ecological factors contributing to the problem; then will propose a health promotion intervention using the social action theory at the community level to decrease work-related low back pain in physical therapists while simultaneously addressing the culture of physical therapy.     

Social work and prostitution: an approach to educational practices

Female prostitution is a diverse, complex reality. And migratory processes are multiple and differ greatly. The conjunction of prostitution and immigration generates new challenges in the professional field of social work; but it is a field that has been able to adapt to the versatility and diversity of this reality. This article sets out to explore the educational dimension developed by social work in this context and to highlight its contents and characteristics: a dimension that takes shape in practices and tasks that enable women who engage in prostitution to realise their capability to manage their life in the way they would like.     

Engaging families in child welfare services: an evidence-based approach to best practice

Successfully engaging clients in the helping process is a critical task for child welfare practitioners. Drop-out and noncompliance rates in child welfare services are high and lead to high rates of removal of children from their families and to eventual termination of parental rights. Although no known interventions guarantee treatment compliance, this review of the empirical literature delineates critical components of engagement in child welfare services. Effective engagement strategies, including service components and caseworker qualities and behaviors, are identified as contributing to the positive case outcomes of treatment compliance, family preservation, and placement prevention. The unique needs of neglectful parents are also examined, with recommendations for practice.     

Teaching social work is teaching to ask questions: an inter-subjective approach to social work practice

Abstract

This paper sets out to provide examples of how quotations from literature can come to and work on a therapist's mind when engaged with clients. A consideration of Sylvia Plath's poetry and writings provide a number of examples of how some knowledge and understanding of her material has contributed to and enhanced work with distressed and disturbed clients. Work with a woman who had made allegations of Satanist abuse is then discussed with particular reference to the relevance of Hamlet to the work. Examples from a therapeutic group are provided which illustrate how literature can function as a communicator of feeling at an unconscious level. Consideration is then given to the wider social and political relevance of subjective feeling with reference to the work of Franz Kafka. There is also acknowledgement of how recourse to literature could be used as a defence against painful material rather than contributing to an understanding of it. The paper concludes with an attempt to understand why it is that claims are made for the healing value of literature and the arts and how these healing processes can operate in the therapeutic encounter.     

Interdisciplinary team discussion on work environment issues related to low back disability: a multiple case study

From both a social and cost-benefit perspective, disability prevention and associated management strategies for assisting employees with back pain are only successful if they address critical return-to-work (RTW) determining factors present in the workplace, including ergonomic factors. Despite our current knowledge of the importance of an integrated team approach targeting these factors, questions remain regarding the conceptual framework adopted by contemporary rehabilitation teams as it relates to work-oriented interventions to accommodate employees back to work. The purpose of this study was to explore and describe the work environment issues discussed by an interdisciplinary team engaged in the work rehabilitation process of low back disability cases. A qualitative content analysis was conducted for 10 sample cases that underwent a rehabilitation program in Quebec (Canada). Drawing on the results of these analyses, a framework representing a synopsis of practitioners' involvement in the person-environment dynamic is presented and discussed. This study makes a unique contribution to the understanding of the 'real-life' content of an interdisciplinary activity in disability management, thus, helping rehabilitation practitioners to build knowledge on the practical application of a cross-disciplinary framework to address work environment issues during the RTW process of those patients sick-listed due to back pain.     

Women with disabilities making the transition back to work: Psychosocial barriers and interventions

The economic impact of disability on employment, earnings, and education appears to be more devastating for women than for men. Women with disabilities who are making the transition either back into the workforce or into the workforce for the first time often face barriers that are unique to this population. Many researchers have described women with disabilities as having a "double disadvantage" that results in social and psychological barriers to their transition back to work. The purpose of this article is to help vocational and career development programs better address the psychosocial needs of women with disabilities by (a) describing key psychosocial barriers faced by women with disabilities in their transition back to work and (b) providing career development strategies designed to ease this transition process for women with disabilities and enhance their employment outcomes.     

The ambivalence of the work of the hotel managers: an approach to ergonomics

This article uses the contributions of ergonomics to understand the work performed by hotel managers. The concern to understand the job of managers is something new in the ergonomics and few studies address this issue, especially in what concerns the work of hotel managers and its aspects of performance and health, which is the focus of this article. Through a literature review on the subject, it is sought to understand the managers' work activity, the impacts on their health and their organizational performance, as managers take an ambivalent position in organizations, since they have to deal directly with the demands of upper and lower hierarchies in a context of high competition, organizational changes and user requirements. It is then inferred there is a risk of increased work density for managers, bringing negative consequences to their health and organizational performance. This phenomenon, still poorly covered by ergonomics, contributes to a certain invisibility of the manager's work in society as a whole, when the manager may suffer from health problems, which are also common in certain populations of workers who do not take the managerial function.     

From counselling to community work: Developing a framework for social work practice with displaced persons

Abstract

This paper represents the outcome of a process of reflection during and following a practice experience with 400 displaced persons from Kosova who were accommodated in southern Tasmania in 1999. Engaged to provide counselling services, the authors experienced misgivings from the outset that this alone would be an effective and appropriate response to people in circumstances of continuing displacement and uncertainty. The paper describes the evolution of services from counselling to community work, discusses emergent practice issues and identifies key principles for future practice.     

Identifying underlying principles in social work law: A teaching and learning approach to the legal framework of decision making

Courses in social work law need to ensure that students know, understand and can apply specific rules of law. However, the sheer volume of law affecting social work and the rapidity with which that law changes require courses in social work law not just to ensure that, but that they are equipped to manage changes in the law. In order to be able to do this, it is argued, the general principles underlying those individual legal rules need to be identified and understood. Students and practitioners need to have educational and professional skills at a higher level of transferability than merely acquiring knowledge of specific legal rules can provide. We use the legal framework of decision making to explain the importance of this approach. The principles of administrative law have been identified as a major component in social work law, and, despite limited exposition in social work law texts, we outline the teaching and learning strategy we have pursued in relation to this topic. |em|We argue that there are thus both educational and practice based reasons for the approach advocated, which we also believe accord with wider imperatives of social work education.     

Factors contributing to low back pain among professional drivers: a review of current literature and possible ergonomic controls

It is suggested that professional drivers are at an increased risk for low back pain and injury due to a variety of factors such as whole body vibration, prolonged sitting, awkward postures, lifting and carrying, and psychosocial issues. Ergonomics can play an important role in the reduction of risk of injury to the professional driver by implementing modifications to the work place (engineering controls), changes in administrative and management practice (administrative controls), and education of the worker (work practice controls). A review of the literature of the etiology of low back pain and injury among professional drivers is presented, and possible ergonomic controls have been recommended.