| 1. |
- Stigmar, Kjerstin, et al.
(författare)
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How do physiotherapists perceive their role in work ability assessments? A prospective focus group study.
- 2014
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Ingår i: Primary Health Care Research and Development. - 1463-4236. ; 15:3, s. 268-276
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Work ability and work ability assessments have become important both in health care and in relation to granting sick leave. There are different interpretations of work ability among the different professionals involved, and there is no consensus on how work ability should be assessed. Aim The aim was to analyse how a group of experienced and specially trained physiotherapists (PTs) in primary health care (PHC) perceived their professional role in work ability assessments during 14 months. METHODS: We conducted a prospective focus group study and applied qualitative content analysis to the data. Findings There was a need to emphasise the PTs' role both within PHC and also in relation to others involved. The PHC organisation was not really prepared to direct work-disabled patients to PTs before physicians. In addition, the PTs themselves needed to reorganise to better meet the requirements. The PTs underlined the advantage of their frequent and extended meetings with patients. This made it possible to assess, follow and facilitate work ability and to determine patients' resources. The PTs believed that they could contribute to structured assessments, which was positive for themselves and also in their communication with physicians and patients. The PTs later took more initiatives in work ability questions and believed that they could be responsible for work ability assessments to a greater extent. They found it most valuable to have had the opportunity to reflect on work ability, while working in the focus groups, and also to have been the subjects for further education. This made them more prepared to handle work ability questions when compared with other colleagues.
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| 2. |
- Stigmar, Kjerstin, et al.
(författare)
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Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Musculoskeletal disorders (MSDs) are a major reason for impaired work productivity and sick leave. In 2009, a national rehabilitation program was introduced in Sweden to promote work ability, and patients with MSDs were offered multimodal rehabilitation. The aim of this study was to analyse the effect of this program on health related quality of life, function, sick leave and work ability. Methods: We conducted a prospective, observational cohort study including 406 patients with MSDs attending multimodal rehabilitation. Changes over time and differences between groups were analysed concerning function, health related quality of life, work ability and sick leave. Regression analyses were used to study the outcome variables health related quality of life (measured with EQ-5D), and sick leave. Results: Functional ability and health related quality of life improved after rehabilitation. Patients with no sick leave/disability pension the year before rehabilitation, improved health related quality of life more than patients with sick leave/disability pension the year before rehabilitation (p = 0.044). During a period of -/+ four months from rehabilitation start, patients with EQ-5D >= 0.5 at rehabilitation start, reduced their net sick leave days with 0.5 days and patients with EQ-5D <0.5 at rehabilitation start, increased net sick leave days with 1.5 days (p = 0.019). Factors negatively associated with sick leave at follow-up were earlier episodes of sick leave/disability pension, problems with exercise tolerance functions and mobility after rehabilitation. Higher age was associated with not being on sick leave at follow-up and reaching an EQ-5D >= 0.5 at follow-up. Severe pain after rehabilitation, problems with exercise tolerance functions, born outside of Sweden and full-time sick leave/disability pension the year before rehabilitation were all associated with an EQ-5D level < 0.5 at follow-up. Conclusions: Patients with MSDs participating in a national work promoting rehabilitation program significantly improved their health related quality of life and functional ability, especially those with no sick leave. This shows that vocational rehabilitation programs in a primary health care setting are effective. The findings of this study can also be valuable for more appropriate patient selection for rehabilitation programs for MSDs.
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| 3. |
- Stigmar, Kjerstin, et al.
(författare)
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Work ability: Concept and assessment from a physiotherapeutic perspective. An interview study.
- 2011
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040.
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to ascertain experiences and perceptions among physiotherapists (PTs) in Sweden regarding the concept of work ability as well as their perspectives of their professional role in work ability assessments. We conducted an in-depth interview study with four male and twelve female physiotherapists working in the field of occupational health care, orthopaedics, primary health care or rehabilitation. Qualitative content analysis was applied to the data. Work ability was perceived as the ability to perform work tasks as requested. Having the potential to adjust at work and to allocate resources, having an attachment to the workplace and time factors were vital. The physiotherapists were striving for a well-defined role within a multiprofessional team, where work ability assessments were performed in a real work environment. The PTs experienced contradictory roles in relation to the patient but believed they could contribute with valuable material for assessments; this professional help was not always requested. It was noted that there was a need for experience and further education to enable PTs to further engage in work ability assessments. It is important to improve collaboration and to further discuss the work ability concept from the viewpoints of different professionals.
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| 4. |
- Stigmar, Kjerstin, et al.
(författare)
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Work ability - experiences and perceptions among physicians.
- 2010
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; Apr 7, s. 1780-1789
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To describe experiences and perceptions of work ability and how it can be assessed among Swedish physicians. Method. We interviewed eight men and six women in the fields of general practice, occupational health, rehabilitation and orthopaedic surgery. Qualitative content analysis was applied to the data. Results. The approach striving to support the patient in mutual confidence was what primarily affected how work ability was understood and how it could be assessed. Two main categories, with sub categories were settled: familiar but vague, with subcategories conflicting expectations and relations and consensus within speciality and the second main category relying on intuition and examinations, with sub categories life as a whole, reasonableness, progression plan, external obstacles and need for knowledge and collaboration. Conclusions. We found that physicians mainly rely on what patients were telling about their work situation when assessing work ability. But it was not clear if they should consider the patient's whole life situation, motivation and wishes. Protecting the physician-patient relationship was seen as important as well as the need for teamwork assessments and increased work place knowledge.
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| 5. |
- Stigmar, Kjerstin
(författare)
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Work ability- Health professionals' perspectives and rehabilitation outcomes
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to deepen the understanding of work ability by analyzing how different health professionals experience and perceive work ability and assessments of work ability, and also by analyzing rehabilitation outcomes that are related to work ability. The focus has been on musculoskeletal disorders with associated psychosocial factors. Method. The general approach was inductive and explorative. In studies I and II, in-depth interviews with physicians (n=14) and physiotherapists (n=16) were conducted, while study III comprised five focus groups within a group of experienced and specially trained physiotherapists (n=7). Qualitative content analysis was applied to the data. Study IV comprised a predefined cohort (n=406), consisting of individuals with musculoskeletal disorders, all included in the national rehabilitation program. All patients were offered multimodal rehabilitation including evidence-based interventions with the aim of promoting work ability. The cohort was studied in order to find out how the patients responded to the rehabilitation and also what factors were associated with health-related quality of life and sick leave. Results. Physicians and physiotherapists shared a holistic view of work ability and wanted to represent and support the patient. They experienced contradictory roles in relation to the patient. More extensive collaboration within health care was desired, but this was not always possible. The physiotherapists wanted to take part in assessments, but felt that they were not always asked to. To be able to take part, experience and further education were needed. Collaboration was also requested with other involved parties, such as occupational health services, the Social Insurance Agency and the employer. There was a need for better knowledge concerning the workplaces. After education and specially training, PTs took more initiatives. They believed that they could contribute with structured work ability assessments and benefitted from continuity. There was need to emphasize the PT role in the organizations. Patients in the national rehabilitation program improved health-related quality of life and function. Patients with no sick leave or disability pension the year before rehabilitation seemed to benefit more from the program. Compared to patients with sick leave or disability pension the year before rehabilitation, a minor proportion within this group reported work ability limitations after completing the program. Limitations with exercise tolerance functions and sick leave history were associated with being on sick leave and having lower health-related quality of life at follow-up.
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