Exploring return to work barriers through the lens of model of human occupation. The NOW WHAT project.

BACKGROUND: The challenges of returning to work after sickness absence demands a wide conceptual understanding of what hinders the employee's work participation. Thus, there is a need to know more about self-perceived barriers for Return to Work (RTW). AIM: This study aimed to investigate RTW barriers experienced by employees on long-term sick leave, through the lens of the Model of Human Occupation (MOHO). MATERIAL AND METHODS: The study was a large-scale qualitative interview study (n = 85) using semi-structured telephone interviews. Eligible participants had received sick leave benefits for between 6 months and 1.5 years. The data were analysed with quantitative and qualitative content analysis. A deductive approach using the MOHO concepts guided the analysis process. RESULTS: The study generated 941 coded meaning units describing barriers for RTW, of which we were able to code 895 within the framework of MOHO. In the person-specific concepts, performance capacity barriers were most often described (n = 303), followed by volitional barriers (n = 165) and barriers related to habituation (n = 66). Barriers related to the environmental components amounted to 361. Barriers in the occupational environment was dominant (n = 214). CONCLUSION: Experienced barriers related to both environmental components and person-specific concepts. SIGNIFICANCE: The habituational and volitional perspective on barriers can contribute to the identification and communication of performance capacity-related barriers not previously identified.

"Being Holistic Is a Lot to Ask": A Qualitative, Cross-National Exploration of Occupational Therapists' Perceptions and Experiences of Holistic Practice.

Being holistic is often used by occupational therapists to describe their practice and philosophy worldwide. This study explores the perspectives of 33 occupational therapists, working in 13 different countries, on their understanding of holistic epistemology and practice and how they seek to incorporate holism in their work. On the basis of a qualitative study design, individual interviews were conducted with the participants by 18 Norwegian undergraduate occupational therapy students, supported by their supervisors. The authors subsequently analyzed the transcribed data, using a thematic analysis approach. Three principal themes emerged: (1) holism as a broad and narrow concept, (2) being holistic spans from treating body parts to teaching marginalized children, and (3) being holistic is a lot to ask. When talking about holism and holistic practice, participants described their holistic practices in various ways, and their accounts reflected different understandings and cultural contexts. Participants characterized a holistic approach as one emphasizing the importance of occupations and activities and helping patients regain independence in their everyday lives. However, they also highlighted the specific challenges they faced, including cultural factors and inadequate resources. Significantly, participants from both Western and non-Western contexts emphasized the importance of holistic practice, suggesting that a dichotomous understanding of Eastern versus Western philosophical approaches does not necessarily make sense in occupational therapy interventions. Therapists' degree of commitment to client-centered practice appears of greater relevance. With its international perspective, our study sheds light on important areas of contemporary occupational therapy practice, including the difficulties occupational therapists face when seeking to cover "everything" in an effort to be more holistic.

Who initiates and organises situations for work-related alcohol use? The WIRUS culture study.

AIMS: Alcohol is one of the leading causes of ill health and premature death in the world. Several studies indicate that working life might influence employees' alcohol consumption and drinking patterns. The aim of this study was to explore work-related drinking situations, with a special focus on answering who initiates and organises these situations. METHODS: Data were collected through semi-structured group interviews in six Norwegian companies from the private ( n=4) and public sectors ( n=2), employing a total of 3850 employees. The informants ( n=43) were representatives from management and local unions, safety officers, advisers from the social insurance office and human-resource personnel, health, safety and environment personnel, and members from the occupational environment committee. Both qualitative and quantitative content analyses were applied in the analyses of the material. RESULTS: Three different initiators and organisers were discovered: the employer, employees and external organisers. External organisers included customers, suppliers, collaborators, sponsors, subcontractors, different unions and employers' organisations. The employer organised more than half of the situations; external organisers were responsible for more than a quarter. The differences between companies were mostly due to the extent of external organisers. CONCLUSIONS: The employer initiates and organises most situations for work-related alcohol use. However, exposure to such situations seems to depend on how many external relations the company has. These aspects should be taken into account when workplace health-promotion initiatives are planned.

Do psychological job demands, decision control and social support predictreturn to work three months after a return-to-work (RTW) programme? The rapid-RTW cohort study.

BACKGROUND: Long-term sickness absence is a considerable health and economic problem in the industrialised world. Factors that might predict return to work (RTW) are therefore of interest. OBJECTIVE: To examine the impact of psychosocial work characteristics on RTW three months after the end of a RTW programme. METHODS: A cohort study of 251 sick-listed employees from 40 different treatment and rehabilitation services in Norway recruited from February to December 2012. The Job Content Questionnaire was used to gather information on the psychosocial work conditions. Full or partial RTW was measured three months after the end of the RTW programme, using data from the national sickness absence register. Logistic regression analyses were performed to investigate the association between the psychosocial work characteristics and RTW. RESULTS: Having low psychological job demands (OR = 0.4, 95% CI: 0.2-0.9), high co-worker- (OR = 3.4, 95% CI: 1.5-5.8), and supervisor support (OR = 3.4, 95% CI: 1.6-7.3), and being in a low-strain job (low job demands and high control) (OR = 4.6, 95% CI: 1.1-18.6) were predictive of being in work three months after the end of the RTW programme, after adjusting for several potential prognostic factors. CONCLUSION: Interventions aimed at returning people to work might benefit from putting more emphasise on psychosocial work characteristics in the future.