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Work ability- Health professionals' perspectives and rehabilitation outcomes

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Author

Summary, in English

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.

Publishing year

2012

Language

English

Publication/Series

Lund University Faculty of Medicine Doctoral Dissertation Series

Volume

2012:88

Document type

Dissertation

Publisher

Division of Physiotherapy, Dept of Health Sciences

Topic

  • Physiotherapy

Keywords

  • Work ability
  • sick leave
  • physiotherapy
  • rehabilitation
  • musculoskeletal disorders

Status

Published

Research group

  • Human Movement: health and rehabilitation

Supervisor

  • Birgitta Grahn
  • Charlotte Ekdahl
  • Lars Borgquist

ISBN/ISSN/Other

  • ISSN: 1652-8220
  • ISBN: 978-91-87189-51-7

Defence date

6 December 2012

Defence time

13:00

Defence place

Health Sciences Centre, hörsal 01, Baravägen 3, Lund

Opponent

  • Kerstin Ekberg (professor)