Directions for advancing the study of work transitions in the 21st century.

OBJECTIVES: The purpose of this article is to share the details, outcomes and deliverables from an international workshop on work transitions in London, Ontario, Canada. PARTICIPANTS: Researchers, graduate students, and community group members met to identity ways to advance the knowledge base of strategies to enhance work participation for those in the most disadvantaged groups within society. METHODS: A participatory approach was used in this workshop with presentations by researchers and graduate students. This approach included dialogue and discussion with community members. In addition, small group dialogue and debate, world cafe discussions, written summaries of group discussion and reflection boards were used to bring new ideas to the discussion and to build upon what we know. FINDINGS: Two research imperatives and six research recommendations were identified to advance global dialogue on work transitions and to advance the knowledge base. Occupational justice can be used to support future research directions in the study of work transitions. CONCLUSIONS: Moving forward requires a commitment of community of researchers, clinicians and stakeholders to address work disparities and implement solutions to promote participation in work.

Measuring workplace social support for workers with disability.

INTRODUCTION: Social support in the workplace has been has been demonstrated to serve as a contributor to a worker's ability to manage work demands and to manage stress. Research in the area of disability management indicates that interpersonal factors play an important role in the success of return-to-work interventions. The role of workplace support has received limited attention in rehabilitation, despite the salience of support to the disability management process. Prior to this study, there existed no validated quantitative measure of social support for workers who re-enter the workplace following injury or disability. METHODS: A support measure prototype, the Support for Workers with Disability Scale, was tested with 152 workers in accommodated work situations. Four validation tools were used to assess criterion validity. Factor analysis was used to validate the content structure and reduce the total number of response items. Additional analysis was conducted to determine the ability of the measure to discriminate between groups, and to provide insight into how social support operates in workplaces. RESULTS: Based on analysis, a reduced measure consisting of 41 items and measuring supervisor, co-worker, and non-work supports was created. Secondary analysis disclosed information concerning the nature of supports in the workplace. Higher levels of support were identified for workers with fewer work role limitations and for those with one versus multiple injury claims. CONCLUSIONS: This tool provides a validated outcome measure for research examining the social aspects of workplace disability. It can also serve as a quality management tool for human resource professionals engaged in continuous improvement of disability management programs.

Community support systems for farmers who live with disability.

To return to farming following the onset of a disabling injury or health condition is predicated on a supportive environment for the farm owner-operator. The purpose of this study was to examine barriers and facilitators of returning to work after an injury or acquired disability, and to identify community supports (formal and informal) needed and available to farmers. This was a qualitative study using a participatory action research approach that involved a research team, an advisory group of seven stakeholder participants and semistructured interviews with farmers, their spouses, and service providers in the study communities. A total of 11 farmers and 17 service providers took part in a focus group or were interviewed individually with or without the spouse present. Focus group discussions and interviews were transcribed and analyzed using constant comparison method and team consensus of findings. Themes of barriers and facilitators for return to farming were identified as health care services, financial and economic issues, and "hands-on" assistance. Themes were organized into an ecological conceptual diagram depicting barriers and facilitators in the microsystem of the farm family, the mesosystem of the local farming community and regional health jurisdictions, and the macrosystem of the province and/or nation's social, legislative, and economic realities. Enhancing community support systems for farmers who become disabled as a result of injury or illness will require a multilevel system approach that involves health, financial, and labor resources.

Farming with a disability: literature from a Canadian perspective.

BACKGROUND: Farmers who live with a disability face multiple challenges that impact their ability to continue farming. The purpose of this article was to review the literature concerning the impact of a disability on farmers' work and life. METHOD: Six electronic databases were searched for articles published in English, from 1992 to 2009. RESULTS: Farmers experience disability caused by injury or illness, which may be physical, cognitive, or affective in nature. The review yielded limited information on the physical and social/emotional impact faced by farmers with disabilities. CONCLUSION: Further intervention research is needed, especially concerning strategies that help disabled farmers to continue farming.

The effect of alternate style keyboards on severity of symptoms and functional status of individuals with work related upper extremity disorders.

UNLABELLED: There is evidence that performing job tasks involving repetition, vibration, sustained posture or forceful movement may contribute to symptoms of work related upper extremity disorders. Typing is one such activity; symptoms that develop as a result of this activity can affect performance of work, self-care and leisure occupations. Studies investigating the impact of ergonomic keyboards on symptom reduction are limited, and little research exists regarding the reduction of key activation force as an intervention. METHODS: This randomized, prospective study used a sample of 68 symptomatic workers employed by a single company. One group received a commercially available ergonomic keyboard, a second group used a modified version of the same keyboard designed to reduce activation force, vibration and key travel. We measured symptoms and clinical signs, functional status, and device satisfaction in both groups over a six-month study period. CONCLUSIONS: Between-groups analyses indicated that the groups performed similarly on the outcomes of interest. Repeated-measure analysis identified a reduction of symptoms, an improvement in functional status, preference for and increased satisfaction with the intervention keyboards, and maintenance of typing speed and accuracy for both groups.

Musculoskeletal injuries among ultrasound sonographers in rural Manitoba: a study of workplace ergonomics.

The purpose of this study was to compare the epidemiology of musculoskeletal injuries and workplace ergonomics among rural-based sonographers compared to urban-based sonographers. The authors also tested the use of a biomechanical software program to assess load on the spine and upper extremity joints. A mail-in survey was sent to all practicing sonographers in rural Manitoba, and on-site video-taped ergonomic and biomechanical evaluations were completed for four sites. Rural-based sonographers appear to have greater work stress related to waiting lists, use of outdated and non-adjustable equipment, and high client load. They also do not advocate for better working conditions because they are few in number and geographically distant from one another. Use of the biomechanical software proved minimally useful. Information related to industry standards and greater collaboration is needed to promote workplace health for sonographers.

Return-to-work: The importance of human interactions and organizational structures.

The purpose of this study was to gain insight into stakeholder perspectives on barriers and facilitators for return-to-work (RTW). Qualitative methodology with purposive sampling was employed. A total of 55 participants, representing a wide spectrum of stakeholders and industry, were interviewed in individual or group format. Interview transcripts were coded, categorized according to themes, and placed within a framework which reflected the dynamic interaction of individuals and the structural systems or context of those individuals. Findings indicated that perceived barriers to RTW included delays of all types in processing or delivery of information or treatment, and ineffective communication among stakeholders. Facilitators to RTW included establishment of RTW programs in the workplace, effective communication and teamwork, as well as trust and credibility among stakeholders. The interdependence of organizational structures and human interactions was evident in successful RTW programs which emphasized teamwork, early intervention, and communication. Differing stakeholder perspectives, however, especially on issues such as worker attitudes and participation, must be acknowledged and addressed if more injured workers are to be successful in returning to full employment.