Louise St-Arnaud

How Well Do Return-to-work Interventions for Musculoskeletal Conditions Address the Multicausality of Work Disability?

Introduction The best-documented return-to-work rehabilitation programs concern workers with musculoskeletal disorders (MSKD). For this clientele, a global perspective has been adopted which explains the multicausality of work disability. This perspective of work disability proposes that return-to-work interventions should address three central elements: individual psychological factors, work environmental factors and factors related to the involvement of the various stakeholders. Long-term work disability is no longer seen simply as the consequence of impairment, but rather as the result of interactions between the worker and main systems: the health care, work environment and financial compensation systems. Methods This paper presents a descriptive content analysis of return-to-work interventions delivered to workers with MSKD which consider this global perspective and which are found to be effective in systematic reviews of the literature. Results The review of programs designed for workers with MSKD showed that eleven programs address the individual clinical and psychological factors, work environmental factors and factors related to the involvement of the various stakeholders, but in different ways. Only two programs met the essential components identified by the literature. These essential components are: centralized coordination of the worker’s return to work, formal individual psychological and occupational interventions, workplace-based interventions, work accommodations, contact between the various stakeholders and interventions to foster concerted action. Conclusions Interventions which involve the work environment and concerted action by the various partners seem to require the most investment in terms of energy. The establishment of common principles and shared values regarding work rehabilitation as well as less divided mechanisms for action among the various partners should be considered.

Factors perceived by employees regarding their sick leave due to depression

Abstract Purpose: Depression is a leading factor of work disability throughout the world. However, a paucity of studies investigated factors related to the development of depression in the workplace prior to sick leave. This qualitative study aims to describe the factors related to the onset of depression at work prior to sick leave. Method: This study followed a descriptive interpretive design. Interviews were conducted with 22 individuals (15 women) who experienced depression while they were employed within an organization. The verbatim transcripts were coded using QDA-Miner software. Results: Participants (n = 22) reported that their depression was partially or completely related to their work. From the analysis of all 22 participants’ interviews transcripts, three major themes emerged: (1) work-related psychosocial risk factors (e.g. factors related to supervisors’ attitudes and behaviors), (2) the individual’s experience in employment (e.g. reactions to symptoms) and (3) the period preceding the sick leave of individuals who experienced depression (e.g. communication with the supervisor). Conclusions: These results support the importance of preventive intervention oriented toward decreasing psychosocial risks within organizations, and detecting workers at risk. Future studies should focus on factors that might influence individuals in their decision to reveal or not their difficulties to their supervisors. Implications for Rehabilitation The conditions in which employees were working before they started their leave of absence should be identified; notably (1) relationships with organizational stakeholders (e.g. immediate supervisor, colleagues) and (2) psychosocial risk factors (e.g. work overload, over-commitment). A good relationship between the immediate supervisor and the employee is an important factor to prevent sick leave due to depression. The supervisors should be informed quickly after the first appearance of depressive symptoms in employees in order to implement feasible and appropriate accommodations as soon as possible.

How Can Supervisors Contribute to the Return to Work of Employees Who have Experienced Depression

Background In Western countries, work disability due to depression is a widespread problem that generates enormous costs. Objective The goal of this study was to determine the types and prevalence of supervisor contributions during the different phases of the return-to-work (RTW) process (before and during the sick-leave absence, and during the RTW preparations) of employees diagnosed with depression. Moreover, we sought to determine which contributions actually facilitate employees’ RTW, and to identify the work accommodations most frequently implemented by supervisors at the actual time of their employee’s RTW. Methods Telephone interviews were conducted in Québec (Canada) with 74 supervisors working with employees who were already back at work or still on sick leave due to depression. A sub-sample of 46 supervisors who had already taken measures to facilitate their employees’ RTW was questioned about the work accommodations implemented. Results Most of the supervisors got along well with their employees before their sick leave and 72% stayed in contact with them during their leave. Nearly 90% of the supervisors encouraged their employees to focus primarily on their recovery before their RTW, but 43% pressured their employees to RTW as soon as possible. Cox regression analyses performed for the entire sample revealed that “the supervisors’ intention to take measures to facilitate their employees’ RTW” was the only significant predictor of the RTW at the time of the interview. The Kaplan–Meier survival curve showed that 50% of the employees were expected to RTW within the first 8 months of absence. Four of the most frequently implemented work accommodations were actions directly involving the supervisor (i.e. providing assistance, feedback, recognition, and emotional support to the employee). Conclusions This study shed light on the less explored point of view of the supervisor involved in the RTW process of employees post-depression. It highlighted the most frequent and effective supervisor contributions to the process. These results can be used to develop concrete action plans for training supervisors to contribute to the sustainable RTW of employees on sick leave due to depression.