Clinician-patient agreement about the work disability problem of patients having persistent pain: why it matters.

Background: Studies from different fields documenting the differences between clinicians' and workers' representations have not elucidated where the differences exist or how they can be resolved.

Purpose: To define and describe scenarios depicting the differences between clinical judgment, workers' representations about their disability and clinicians' interpretations of these representations.

Methods: A multiple case-study design was used.

Health and illness representations of workers with a musculoskeletal disorder-related work disability during work rehabilitation: a qualitative study.

Introduction: Distinctions between disease and illness have been criticized for being too theoretical. In practice, however, it may help explain gaps in understanding and miscommunication between health care professionals and patients/injured workers, since each has their own perception of reality. To reduce the gap between health care professionals and patients in understanding the definition of disease, this paper documents general representations of health, illness and work-related musculoskeletal disorders and their influence on the work rehabilitation program.

Relationship between the margin of manoeuvre and the return to work after a long-term absence due to a musculoskeletal disorder: an exploratory study.

Purpose: The application of the margin of manoeuvre (MM) concept in work rehabilitation is new. It allows for variations in both health status and work demands, and the interaction between the two, to be taken into account. The objective of this exploratory study was to document the relationship between the presence of an MM in the workplace and the return to work (RTW), after a long-term absence.

Transforming the meaning of pain: an important step for the return to work.

Unlabelled: Previous studies have found illness representations to be associated with the degree to which patients adopt health behaviours. Surprisingly, pain representations, especially those in a work rehabilitation context, have rarely been explored.

Objective: To conduct a thorough investigation of the pain representations held by workers who were on sick leave due to persistent musculoskeletal pain during the process of an intensive work rehabilitation program.

A review of assessment tools of illness representations: are these adapted for a work disability prevention context?

Introduction: Musculoskeletal disorders are among the main causes of short- and long-term disability.

Aim: Identify the methods for assessing multidimensional components of illness representations.

Methods: An electronic literature search (French, English) from 1980 to the present was conducted in medical, paramedical and social science databases using predetermined key words.

Decreasing occupational injury and disability: the convergence of systems theory, knowledge transfer and action research.

Many work injuries and their associated disabilities are preventable, but effective prevention requires coordinated action by multiple stakeholders. In trying to achieve coordinated action occupational health practitioners can learn valuable lessons from systems theory, knowledge transfer and action research. Systems theory provides a broad view of the factors leading to injury and disability and a means to refocus stakeholder energies from mutual blaming to effective strategies for system change.

Representations: an important key to understanding workers' coping behaviors during rehabilitation and the return-to-work process.

Introduction: Every year many workers are excluded from work because of a work disability attributable to a musculoskeletal disorder (MSD). Factors associated with the development and persistence of the work disability can be related to the worker, work environment, compensation policies, healthcare system and insurance system. Workers' understanding/representations of their disability are associated with coping behaviors aimed at helping them adapt to or solve their health problem.

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.

Interorganizational collaboration in occupational rehabilitation: perceptions of an interdisciplinary rehabilitation team.

Introduction: Various obstacles to and facilitators of collaboration between an interdisciplinary work rehabilitation team and the stakeholders (workers, insurers, physicians, and employers) exist, but are not well characterized.

Methods: An observational study was conducted, using videotapes of interdisciplinary team discussions of ongoing cases involving 22 workers absent from work due to musculoskeletal disorders. The actions taken and strategies adopted by the team in an effort to overcome the obstacles to collaboration were studied.

Workplace-based return-to-work interventions: optimizing the role of stakeholders in implementation and research.

Introduction: The challenges of engaging and involving stakeholders in return-to-work (RTW) intervention and research have not been well documented.

Methods: This article contrasts the diverse paradigms of workers, employers, insurers, labor representatives, and healthcare providers when implementing and studying workplace-based RTW interventions.

Results: Analysis of RTW stakeholder interests suggests that friction is inevitable; however, it is possible to encourage stakeholders to tolerate paradigm dissonance while engaging in collaborative problem solving to meet common goals.

Training the next generation of researchers in work disability prevention: the Canadian Work Disability Prevention CIHR Strategic Training Program.

Introduction: There is a need to create, disseminate, and implement new knowledge in the work disability prevention (WDP) field. Training programs attracting high-quality applicants and taking into account the complexity of this emerging field are urgently needed.

Methods: An advanced training program, funded by the Canadian Institutes of Health Research (CIHR), was developed by 24 mentors affiliated with nine different universities.

The values underlying team decision-making in work rehabilitation for musculoskeletal disorders.

Purpose: This paper presents the results of a qualitative study on the values underlying the decision-making process of an interdisciplinary team working in a work rehabilitation facility of a Québec teaching hospital.

Methods: In order to document the values underlying the decision-making process, a single case observational study was conducted. Interdisciplinary team weekly discussions on ongoing cases of 22 workers absent from work due to musculoskeletal disorders were videotaped.