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Work ability as obscure, complex and unique: Views of Swedish occupational therapists and physicians
Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
Visa övriga samt affilieringar
2013 (Engelska)Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 45, nr 1, s. 117-128Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The concept of work ability is not clearly defined although it has a central place in vocational rehabilitation. Several health professions are involved in assessing work ability, physicians and occupational therapists are two of these. OBJECTIVE: The purpose of this study was to explore occupational therapist and physician views about work ability and experiences in assessing work ability. PARTICIPANTS: Fourteen physicians and 23 occupational therapists participated in seven focus group discussions that were audio taped and transcribed verbatim. METHODS: Qualitative content analysis was used. Each author performed an individual preliminary analysis. These analyses were later discussed and refined in the research team and a workshop. The final categorization resulted in one theme, four categories and 13 sub-categories. RESULTS: The overall theme expressed work ability as an obscure, complex and unique concept. The four categories illustrate the affecting factors and confirm the complex structure of work ability: the person, the context of life, the work, and the society. Physicians expressed greater difficulty in assessing work ability than occupational therapists did, because they have fewer instruments to access this concept. CONCLUSIONS: Assessment of work ability requires team cooperation with several different professionals. Cooperation could increase accuracy in issuing sickness certification and strengthens the ability of identifying individual requirements for rehabilitation.

Ort, förlag, år, upplaga, sidor
AMSTERDAM, NETHERLANDS: IOS PRESS , 2013. Vol. 45, nr 1, s. 117-128
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Arbetsterapi
Identifikatorer
URN: urn:nbn:se:umu:diva-73590DOI: 10.3233/WOR-2012-1416ISI: 000318769600013OAI: oai:DiVA.org:umu-73590DiVA, id: diva2:632950
Tillgänglig från: 2013-06-25 Skapad: 2013-06-25 Senast uppdaterad: 2018-06-08Bibliografiskt granskad
Ingår i avhandling
1. Primärvårdens arbete med sjukskrivna – patientmötet, bedömningar och samverkan
Öppna denna publikation i ny flik eller fönster >>Primärvårdens arbete med sjukskrivna – patientmötet, bedömningar och samverkan
2015 (Svenska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The ability to work can be reduced if a person has health problems which may lead to periods of sick leave. In Sweden sickness certification is issued by physicians. Many general practitioners (GPs) find sickness certification to be problematic. Some studies indicate that collaboration with other health care professions could be beneficial. The aim of the thesis was to provide knowledge on how the work with the sick leave process in primary health care can be improved and how occupational therapists’ (OT) assessment could be used prior to the decision on sick leave and rehabilitation. Initially seven focus groups were held, four with OTs and three with physicians. The discussions in the focus gropes were analysed by qualitative content analysis. An intervention project was initiated, where four health care centres in northern Sweden tested a working approach where sick listed patients were offered a supplementary assessment of activity and work-related problems by an OT. Data on sick leave, sickness certificates and patient questionnaires were collected from intervention health care centres (IHCC) and other health care centres (OHCC). Interviews were conducted with patients, GPs and OTs. The quality of the information in the collected sickness certificates was evaluated. Average values of sick leave were compared between the IHCCs and the OHCCs in the county. The interviews with sick listed patients were analysed by qualitative content analysis. In order to analyse the implementation of the intervention the Consolidated Framework for Implementation Research, CFIR, was used. An overall theme and four categories emerged from the focus groups. The theme expressed work ability as an obscure, complex and unique concept. The four categories illustrate the affecting factors and confirmed the complex structure of work ability: the person, the context of life, the work, and the society. No significant differences between IHCCs and OHCCs in data on sick leave or the mandatory information in the certificates were found. Thirty-four percent of the collected sickness certificates did not contain all requested information. More certificates issued for women than certificates issued for men lacked the required information. Full-time sick leave was significantly more often prescribed for male patients than for female. Two themes revealed that highlight important areas for persons on sick leave in their healthcare encounters. The theme ‘Trust in the relationship’ contains categories describing the patients’ feelings of participation, being believed, confirmed, and listened to. The second theme ‘Structure and balance’ contains the participants’ views on important factors that could facilitate the return-to-work process such as a structured plan and support to balance activity. The analysis with CFIR clarified that coaching and education for all the users are crucial to get fidelity when new interventions are tested as well as involvement by the clinical department manager. The work with sick leave issues in primary health care can be improved by developing cooperation with several different professionals. To achieve an increased cooperation new working approaches are required. These working approaches must be anchored in management and requires an applied implementation strategy. More focus on the quality of encounters with healthcare professionals can also improve the sick leave process in primary health care centres. The healthcare encounters must build on a mutual trust and sick-listed persons’ return to work can be facilitated by providing a clear structure in the process and support in occupational balance. For issuing sickness certification further education about the descriptions of functioning and the tasks included in the patient’s work is needed. A better gender awareness in the health care encounters is also necessary.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2015. s. 96
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1744
Nyckelord
Primary health care, Sickness certification, Work ability, Health care encounters, Occupational Therapy, Return to work
Nationell ämneskategori
Arbetsterapi Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Identifikatorer
urn:nbn:se:umu:diva-109757 (URN)978-91-7601-332-8 (ISBN)
Disputation
2015-10-29, Aulan Vårdvetarhuset, Umeå universitet, Umeå, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2015-10-08 Skapad: 2015-10-05 Senast uppdaterad: 2018-06-07Bibliografiskt granskad

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Work: A journal of Prevention, Assesment and rehabilitation
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologiArbetsterapi

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