Towards a new definition of return-to-work outcomes in common mental disorders from a multi-stakeholder perspective.
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ABSTRACT:
SUBMITTER: Hees HL
PROVIDER: S-EPMC3386986 | biostudies-other | 2012
REPOSITORIES: biostudies-other
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Project description:BACKGROUND:Although effective return-to-work (RTW) interventions are not widely available for individuals with common mental disorders on sick leave, there is potential for transforming such interventions into a digital solution in an effort to make them more widely available. However, little is currently known about the viewpoints of different stakeholder groups, which are critical for successful development and implementation of a digital RTW intervention in health care services. OBJECTIVE:The aim of this study was to examine stakeholder groups' perspectives on the role and legitimacy of a digital RTW solution called mWorks for individuals with common mental disorders who are on sick leave. METHODS:A purposeful snowball sampling method was utilized to recruit respondents. Semistructured individual and focus group interviews were conducted for stakeholder groups of service users, RTW professionals, and influential managers regarding their experiences, needs, and preferences for mWorks. Content analysis generated themes and categories that constituted the main findings. RESULTS:The legitimacy of a digital RTW solution was high among all stakeholder groups since such a tool was perceived to enable service users to take control over their RTW process. This was mainly a product of accessible support and promotion of service user decision making, which had the potential to empower service users. All respondents stressed the importance of fostering a positive user experience with usability and emphasis on service user resources and strengths, as opposed to various limitations and shortcomings. Stakeholder groups highlighted critical content to facilitate RTW, such as the need to clarify a back-to-work plan, accompanied by an accessible RTW network and strategies for handling mental health problems. Implementation challenges primarily involved influential managers' concern of legislation incompatibility with innovative technology, and RTW professionals' concern of the possibility that digital solutions may replace them to a certain extent. CONCLUSIONS:This formative research emphasizes the importance of shifting power from RTW professionals to service users. mWorks can play a role in mediating service user control over the RTW process, and thereby increase their empowerment. A digital RTW solution may facilitate the circumvention of implementation barriers associated with introducing evidence-based RTW interventions in a traditional RTW context.
| S-EPMC7527904 | biostudies-literature
Project description:Purpose To present an overview of the existing evidence on prognostic factors of (recurrent) sickness absence (SA) and return to work (RTW) among workers with a common mental disorder (CMD). This scoping review provides information about determinants for SA and RTW, which could be used to develop better interventions aimed at the prevention of SA and promotion of RTW among workers with a CMD. Methods Relevant articles were identified in PubMed, Embase, PsycINFO, PSYNDEX, and SINGLE up to October 2016. In order to be included, studies should provide insight into prognostic factors of SA or RTW of workers with a CMD. We classified all factors according to the domains of the International Classification of Functioning, Disability and Health. Results Our searches identified 2447 possible relevant articles, of which 71 were included for data extraction. There is consistent evidence in ?3 studies that previous episodes of CMD, higher symptom severity, previous absenteeism, co-morbidity, high job demands, low job control, high job strain, female gender, lower educational level, smoking behavior, and low perceived general health are predictors of SA in people with CMDs. Earlier RTW is consistently predicted by lower symptom severity, having no previous absenteeism, younger age, and positive expectations concerning sick-leave duration or RTW. Conclusions The amount of research on determinants for SA and RTW in workers with CMD has increased dramatically in recent years, although most studies are from the Netherlands and Scandinavia. There are some research gaps identified in this scoping review that need further attention in primary and secondary studies. Based on the summary of the evidence, we provide guidance for policy, practice and research.
| S-EPMC6096498 | biostudies-literature
Project description:Common mental disorders (CMDs) are risk factors for long-term sickness absence and unemployment. Therefore, return-to-work (RTW) processes have been introduced to facilitate the return of employees. As the success of RTW processes is considered to be determined by the cooperativeness of the involved stakeholders, we aimed to investigate the views of those stakeholders to disclose potentially diverging expectations. Qualitative interviews were conducted (08/2018-04/2019) among five stakeholder groups: returnees with a diagnosed CMD who were eligible for a RTW process; health care professionals nominated by the returnees; supervisors, colleagues and occupational physicians (the latter three groups were not nominated by the returnees). In total, 24 returnees, 13 health care professionals, 13 occupational physicians, 9 supervisors and 9 colleagues were interviewed (68 interviews in total). Potentially diverging expectations of the stakeholders related to whether diagnoses need to be disclosed by returnees. Agreement existed in terms of the need for a trustful relationship between employees and occupational physicians to initiate a RTW process early. As the understanding of all stakeholders' viewpoints is one of the main factors promoting a successful RTW, we explored the expectations of those involved in the RTW process. One implication of our findings is to strengthen the role of occupational physicians, who could coordinate the return process.
| S-EPMC7558125 | biostudies-literature
Project description:BackgroundEffects of return to work (RTW) interventions vary, and more knowledge is needed about the factors that contribute to RTW. This study investigated changes in work participation and mental health, and predictors of RTW among patients being treated for common mental disorders (CMDs).MethodsThe study was a prospective pre-post study of 164 patients treated at an RTW outpatient clinic for CMDs. Differences between before and after treatment were analysed using paired t tests for continuous variables and marginal homogeneity test for categorical variables. Univariable and multivariable logistic regression analyses were used to identify factors associated with RTW. Baseline data (patient characteristics, clinical status, generalized self-efficacy, expectations of future work ability) and treatment variables were used as independent variables in logistic regressions. Further analysis investigated whether improvements in symptoms, work ability, expectations of future work ability and generalized self-efficacy were associated with RTW.ResultsNumber of individuals with full work participation increased, and there were improvements in symptoms, work ability and generalized self-efficacy. In the final model for predicting RTW, baseline work ability and expectancy of future work ability, a history of psychiatric treatment and focus on RTW in the treatment predicted RTW. Improvement in expectations of future work ability at post-treatment did also predict RTW.ConclusionsAssessing work ability and expectations of RTW at the beginning of treatment is recommended to identify patients at risk of long-term sick leave. Individuals with a history of psychiatric treatment are also risking long-term work disability. It is essential that treatment focus not only on symptom-relief, but also on improving work ability and expectations of RTW. An RTW-focused approach in therapy is associated with RTW.Trail registrationClinicalTrails.gov ID NCT01181635 . Registered 08/12/2010.
| S-EPMC5516307 | biostudies-literature
Project description:AimsThe current study aimed to: (i) describe the extent of overall stigma as well as the differences in stigma towards people with alcohol abuse, dementia, depression, schizophrenia and obsessive compulsive disorder, as well as (ii) establish the dimensions of stigma and examine its correlates, in the general population of Singapore, using a vignette approach.MethodsData for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. The study population comprised Singapore Residents (Singapore Citizens and Permanent Residents) aged 18-65 years who were living in Singapore at the time of the survey. All respondents were administered the Personal and Perceived scales of the Depression Stigma scale and the Social Distance scale to measure personal stigma and social distance, respectively. Weighted mean and standard error of the mean were calculated for continuous variables, and frequencies and percentages for categorical variables. Exploratory structural equation modelling and confirmatory factor analysis were used to establish the dimensions of stigma. Multivariable linear regressions were conducted to examine factors associated with each of the stigma scale scores.ResultsThe mean age of the respondents was 40.9 years and gender was equally represented (50.9% were males). The findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising 'weak-not-sick' and 'dangerous/unpredictable' while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores. Those administered the alcohol abuse vignette were associated with higher social distance scores.ConclusionThis population-wide study found significant stigma towards people with mental illness and identified specific groups who have more stigmatising attitudes. The study also found that having a friend or family member with similar problems was associated with having lower personal as well as social distance stigma. There is a need for well-planned and culturally relevant anti-stigma campaigns in this population that take into consideration the findings of this study.
| S-EPMC5647661 | biostudies-literature
Project description:BackgroundThere is an evident discrepancy between need and provision of evidence-based return-to-work (RTW) interventions in existing mental health services. Online dissemination of evidence-based interventions is presumed to reduce this gap. However, there is almost no knowledge available on perceived acceptability of digital RTW interventions among service users, which are factors that might influence the development and implementation of future interventions. The aim of this study was to develop knowledge of service user acceptability of mWorks, a proposed digital RTW solution.MethodsParticipants (n = 18) with experience of common mental disorder and sick leave were recruited with a purposive snowball sampling method. Semi-structured interviews (n = 12) and one focus group interview (n = 6) were conducted. A deductive thematic analysis was performed according to the Theoretical Framework of Acceptability.ResultsDigital RTW interventions were perceived as acceptable and aligned with participant value. Participants expressed positive attitudes toward having access to support, regardless of time and place. A certain ambiguity between a decline in social interactions and opportunities to RTW in a safe space was reported. Participants were confident in their ability to use digital RTW solutions, but reported the need to reduce stressful elements of using smartphones. Overly demanding digital solutions, i.e. ones requiring high cognitive effort, were described as burdensome.ConclusionsFor digital RTW solutions to be acceptable, they need to complement traditional services by providing accessible and person-centred support throughout the RTW process. They should be designed to reduce the need for cognitive effort. Future research should explore how to balance user autonomy with other support components in digital interventions.
| S-EPMC8336332 | biostudies-literature
Project description:PurposeCommon mental disorders (CMDs) are major causes of sickness absence and disability. Prevention requires knowledge of how individuals perceive causal mechanisms, and in this study we sought to examine work-related factors as causal attribution of CMDs.MethodsA trial sample of n = 1,193, recruited because they struggled with work participation due to CMDs, answered an open-ended questionnaire item about what they believed were the most important causes of their CMDs. The population included participants at risk of sickness absence, and participants with reduced work participation due to sickness absence, disability or unemployment. We used thematic content analysis and categorized responses from 487 participants who reported work-related factors as causal attributions of their CMDs. Gender differences in work-related causal attributions were also examined.ResultsThe participants attributed their CMDs to the following work-related factors; work stress, leadership, reduced work participation, job dissatisfaction, work conflict, social work environment, job insecurity and change, workplace bullying, and physical strain. Women tended to attribute CMDs to social factors at work.ConclusionFindings from this study suggest several work-related risk factors for CMDs. Both factors at the workplace, and reduced work participation, were perceived by study participants as contributing causes of CMDs. Thus, there is a need to promote work participation whilst at the same time targeting aversive workplace factors. Further, our findings indicate that work-related factors may affect women and men differently. This illustrates that the association between work participation and CMDs is complex, and needs to be explored further.
| S-EPMC4540770 | biostudies-literature
Project description:BackgroundCommon mental disorders present the main reason for registered sick leave in Sweden today, and women are at a higher risk of such sick leave than men. The aim of this paper is to explore how employees on sick leave for common mental disorders experience interventions and rehabilitation activities during return-to-work, as well as to explore similarities and differences between the experiences of the interviewed women and men.Material and methodsA qualitative design was applied with semi-structured focus group interviews. Seven focus groups were conducted with a total of 28 participants (13 women and 15 men). The focus group discussions were audiotaped and transcribed verbatim, and data analyzed with conventional content analysis. Similarities and differences in the women's and men's experiences were written down in reflective notes during all steps of the analysis.ResultsThe results comprise of one main category, "To be met with respect and recognition", and subcategories at two levels. Both similarities and differences emerged in how women and men sick-listed because of common mental disorders experienced return-to-work interventions and rehabilitation activities. It was important for both women and men to be met with respect and recognition, which was essential to all forms of help that the participants discussed during the focus group interviews. Women expressed a need for home-related interventions, whereas men expressed a need for organizational interventions to counter feelings of resignation at work. Women could also more easily understand their mental health condition as compared with men.ConclusionA key implication of this study is that research on interventions and rehabilitation activities during return-to-work among employees on sick leave for common mental disorders should consider whether the findings are relevant equally to both women and men. Similarly, return-to-work professionals may need to consider possible differences among women and men on sick leave for common mental disorders, and to further customize offered interventions and rehabilitation activities. Doing so may help enhance the effectiveness of such interventions.
| S-EPMC8232439 | biostudies-literature
Project description:Purpose Individual psychosocial factors are crucial in the return to work (RTW) process of workers with musculoskeletal disorders (MSDs) and common mental disorders (CMDs). However, the quality and validity of the questionnaires used to measure these factors have rarely been investigated. The present systematic search and literature review aims at identifying, categorizing, and evaluating the questionnaires (measurement tools) used to measure individual psychosocial factors related to the perception of the personal condition and motivation to RTW that are predictive of successful RTW among workers with MSDs or CMDs. Methods Through a systematic search on PubMed, Web of Science, and PsycINFO library databases and grey literature, we identified the individual psychosocial factors predictive of successful RTW among these workers. Then, we retrieved the questionnaires used to measure these factors. Finally, we searched for articles validating these questionnaires to describe them exhaustively from a psychometric and practical point of view. Results: The review included 76 studies from an initial pool of 2263 articles. Three common significant predictors of RTW after MSDs and CMDs emerged (i.e., RTW expectations, RTW self-efficacy, and work ability), two significant predictors of RTW after MSDs only (i.e., work involvement and the self-perceived connection between health and job), and two significant predictors of RTW after CMDs only (i.e., optimism and pessimism). We analyzed 30 questionnaires, including eight multiple-item scales and 22 single-item measures. Based on their psychometric and practical properties, we evaluated one of the eight multiple-item scales as questionable and five as excellent. Conclusions: With some exceptions (i.e., self-efficacy), the tools used to measure individual psychosocial factors show moderate to considerable room for improvement.
| S-EPMC8298352 | biostudies-literature
Project description:Background Common mental disorders present the main reason for registered sick leave in Sweden today, and women are at a higher risk of such sick leave than men. The aim of our study was to explore how the experiences of work- and home-related demands as well as resources influence return-to-work among employees sick-listed for common mental disorders in Sweden. Specifically, we aimed to explore similarities and differences in patterns of experiences among women and men. Methods A qualitative design with semi-structured focus group interviews was applied. One pilot interview and six additional focus groups, with a total of 28 participants, were conducted. The focus group discussions were audiotaped and transcribed verbatim. Data was analyzed with conventional content analysis. Results The analysis resulted in four main categories and eight sub-categories. While the study aim was to explore aspects of work and home, additional considerations related to internal demands and involved actors were also found. The main and sub-categories were “Home-related demands and resources” (sub-categories: “Not on sick leave for home-related demands”, “Feeling responsible for relationships and the well-being of others”, “An affected economy” and “Finding energizing activities and creating routines”), “Work-related demands and resources” (sub-categories: “Encountering tough emotions and an over-bearing feeling of responsibility at work”, “Continued work-related demands create un-certainty about the future”, “Loss of boundaries” and “(Desired) support from managers and colleagues”), “Internal demands and resources” and “Demands and resources linked to involved actors”. The experiences described among women and men were similar in some categories while patterns of experiences differed in others. Conclusions Home-related demands and resources influence return-to-work among women and men sick-listed for common mental disorders in Sweden, also when work-related demands are experienced as the main reason for the sick leave period. Furthermore, several of these aspects were described differently among women and men, which highlights the need to consider possible gender differences in relation to return-to-work, while maintaining attention to individual variations. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10045-4.
| S-EPMC7745371 | biostudies-literature