Occupational Rehabilitation Services Research Articles

산재근로자 특성별 직업복귀와 재활서비스 간의 연관 패턴 분석: 2018-2020년 행정데이터를 중심으로

This study investigated the association between injured workers’ RTW and occupational rehabilitation in South Korea. Two hundred and ninety individuals with occupational injuries from 2018 to 2020 were analyzed using the cluster analysis and pattern analysis
 methods to identify their characteristics and significant correlations regarding the combination of rehabilitation services contributing to injured workers’ RTW within each cluster. The study unveiled crucial findings. Firstly, rehabilitation services significantly enhanced successful RTW across all clusters. Particularly, for workers under unstable and precarious employment, these services facilitated their transition into a stable institutional framework, resulting in positive labor market reintegration. Secondly, differences in rehabilitation service patterns were found to be contingent on the types of accident-related and illness-related injuries. Thirdly, rehabilitation services for occupational injuries were categorized into three groups based on usage frequency and identified association patterns. Finally, the provision of occupational injury rehabilitation services tended to lean heavily towards a one-dimensional model, primarily involving singular relationships between operating institutions or individual professionals and workers. This structure emphasized a more limited scope, lacking broader systemic involvement or multidimensional approaches.

Rehabilitation professionals' perspectives of factors influencing return to occupation for people with lower limb amputation in East, South, and Southeast Asian developing countries: A qualitative study.

To identify barriers and enablers for return to occupation (RTO) for people with lower limb amputation (LLA) in East, South, and Southeast Asian developing countries from the perspective of rehabilitation professionals. A convenience sample of rehabilitation professionals working in Asian developing countries participated in online in-depth interviews between September 2021 and February 2022. Interview transcripts were analyzed and thematically coded to the modified Health Care Delivery System Approach (HCDSA) framework. COREQ guidelines were followed. Twenty-eight interviewees from 13 countries shared their experiences of factors related to RTO for people with LLA. Identified factors described barriers and facilitators for RTO at all four HCDSA framework levels. The "environmental" level had the most identified factors (n = 56) and the "care team" level the least (n = 31). Common environmental RTO challenges included cultural attitudes to women; lack of rural/remote services; inadequate numbers and regulation of rehabilitation professionals; inappropriate prosthesis; limited government support for rehabilitation, and reliance on charitable models. Despite varied cultural, religious, and geographical characteristics, consistent factors impacting RTO were identified within these thirteen countries. Identified barriers to RTO underline the need for improvements throughout service systems from the acute-care focus on saving life without consideration of RTO, the rehabilitation focused primarily on mobility, to the lack of occupational rehabilitation services and supporting policy in these countries. These interlinked factors at different levels of healthcare service systems reinforce the importance of systems approaches to best utilize limited resources toward improving RTO in this region.

Smart Work Injury Management (SWIM) System: A Machine Learning Approach for the Prediction of Sick Leave and Rehabilitation Plan.

As occupational rehabilitation services are part of the public medical and health services in Hong Kong, work-injured workers are treated along with other patients and are not considered a high priority for occupational rehabilitation services. The idea of a work trial arrangement in the private market occurred to meet the need for a more coordinated occupational rehabilitation practice. However, there is no clear service standard in private occupational rehabilitation services nor concrete suggestions on how to offer rehabilitation plans to injured workers. Electronic Health Records (EHRs) data can provide a foundation for developing a model to improve this situation. This project aims at using a machine-learning-based approach to enhance the traditional prediction of disability duration and rehabilitation plans for work-related injury and illness. To help patients and therapists to understand the machine learning result, we also developed an interactive dashboard to visualize machine learning results. The outcome is promising. Using the variational autoencoder, our system performed better in predicting disability duration. We have around 30% improvement compared with the human prediction error. We also proposed further development to construct a better system to manage the work injury case.

The impact of COVID-19 on Occupational Therapy services in Gauteng Province, South Africa: a qualitative study

The impact of COVID-19 on healthcare services has been widely reported, but limited information is available on its impact on rehabilitation services in South Africa. This article reports on the impact of COVID-19 on Occupational Therapy services and programmes in public and private health care as delivered by occupational therapists. A qualitative case study design was selected to explore the perceptions of occupational therapists in private and public healthcare settings regarding the impact of COVID-19 on rehabilitation services. Asynchronous on-line focus group interviews were conducted by a team of researchers. The data were thematically analysed. Three themes emerged from the data. Theme 1, the ‘impact on the practice context’, revealed that infection prevention and control protocols were a barrier to achieving rehabilitation goals. An enabler was the therapists’ creativity and new ways of practice. Theme 2 described the ‘impact on the service-users’ where isolation and physical distancing curbed access to rehabilitation services. The struggle of vulnerable populations and socio-economic disparities in healthcare was evident in these data. Theme 3 referred to changes in the ‘professional and personal self’ of the occupational therapists. Challenges to ethical practices − for example, the uncertainty of the benefit of adapted services − resulted in stress and anxiety among therapists. Constantly adapting to changes in Regulations caused compassion fatigue, but therapists also reported healthy coping strategies and resilience. Occupational Therapy rehabilitation services should be listed as essential in times of a pandemic. Better health and social support to vulnerable populations should be established, as their challenges escalated during COVID-19. Research is required to determine practice guidelines and effectiveness of novel rehabilitation practices that were identified during the COVID-19 pandemic.

Chronic lower back pain in aquaculture clam farmers: adoption and feasibility of self-management strategies introduced using a rapid prototype participatory ergonomic approach

Objectives. Lower back pain (LBP) is extremely prevalent in seafood harvesters who often have limited or no access to ergonomic consultation, occupational health support and rehabilitation services. This pilot study aimed to describe a participatory ergonomic approach and determine the feasibility and extent of adoption of self-management strategies in clam farmers with LBP. Methods. A rapid prototype participatory ergonomic approach was used to develop context-specific self-management strategies. Options to adjust lifting and repetitive stress were introduced using video clips, demonstrations and discussions in the workplace. Workers chose and implemented three strategies for 8 weeks with weekly reminders. Survey and qualitative data from focus groups were analyzed. Results. Team strategies were the most popular, but individual options were used more often. Strategies were considered feasible, acceptable and relatively easy to use. Strategies were implemented relatively consistently, and most improved productivity with decreased pain. Challenges for uptake included changing habit, culture and team dynamics. Conclusions. Participatory rapid prototyping provided a feasible and efficient option to introduce strategies for clam farmers with small teams, variable work processes and workloads, and time restrictions. Strategies were considered acceptable and easy to use, and most increased productivity. These methods show potential for future research.

Interventions in the Scope of Occupational Therapy to Improve Psychosocial Well-Being in Older Adults with Low Vision and Mental Health Concerns: A Systematic Review

Research has found that occupational therapy practitioners focus on functional and participation outcomes in the low vision population, but overlook corresponding psychosocial outcomes in rehabilitation. The purpose of this systematic review is to answer the PICO question: “What is the evidence to support interventions within the scope of occupational therapy for improving psychosocial well-being or quality of life in adults experiencing depression or anxiety as a result of low vision?” The team conducted a search of literature published between 2008 and 2020. Inclusion criteria consisted of interventions within the scope of occupational therapy for patients with low vision, and which measured mental health or quality of life factors. Eleven articles met inclusion criteria. The majority of the evidence consisted of 1B (45%) and 2B (36%) level randomized control trials. Two studies were 3B level evidence. Mental health outcomes were measured primarily using depression rating scales, although a number of studies also utilized vision-specific quality of life questionnaires. Established intervention themes included behavioral activation plus occupational therapy low vision rehabilitation, cognitive problem-solving approaches, usual care ‘plus’ skill-based training, and group service delivery approaches. Moderate evidence supports behavioral activation plus occupational therapy low vision rehabilitation, problem-solving approaches, and group service delivery approaches for improving mental health outcomes. There is moderate evidence that does not support usual treatment ‘plus’ skill-based training to improve mental health.

Contextual, Client-Centred Coaching Following a Workshop: Assistants Capacity Building in Special Education.

Assistants serve an essential role in special education to support children with disabilities, but they should be properly trained and supervised. The coaching approach represents one trend that has been gradually implemented in occupational therapy (OT) and rehabilitation services. Still, few studies clearly define the coaching intervention, measure the fidelity of coaching practices, or evaluate capacity building of the caregivers in the long term. This quasi-experimental study compared one-on-one coaching in natural environments following a workshop with a training workshop. Both public schools do not have regular OT services. The primary outcome was the assistant’s performance, measured with the Goal Attainment Scaling (GAS). The secondary outcome was the fidelity of coaching implementation, measured with the Coaching Practices Rating Scale (CPRS). The GAS showed an increased performance of the assistants after the intervention, with significant differences between groups post-intervention (p = 0.015) and large effect size (r = 0.55), but no long-term significant improvements were found at the follow-up (p = 0.072). The CPRS showed an adequate implementation of the five coaching components (joint planning, observation, action, reflection, and feedback), with a total score of 3.5 ± 0.72 (mean ± SD). The results suggest that coaching sessions provided by OTs in schools may improve assistants’ skills to facilitate the student’s participation.

Investigating feasibility and preliminary efficacy of a simulator-based driving intervention for people with acquired brain injury: A randomised controlled pilot study

Objective: To investigate the feasibility and preliminary efficacy of a driving simulator intervention on driving outcomes following acquired brain injury. Design: Pilot randomised controlled trial. Setting: Occupational therapy driver assessment and rehabilitation service. Subjects: Individuals post-acquired brain injury aiming to return to driving. Intervention: Eight sessions of simulated driver training over four weeks, in addition to usual care. Control: Usual care only. Main measures: Feasibility outcomes: Participant recruitment and retention; data completeness; therapy attendance and fidelity; adverse events. Performance outcomes: on-road driving performance; Simulator Sickness Questionnaire; Brain Injury Driving Self-Awareness Measure and Driving Comfort Scale – Daytime, assessed at baseline and five weeks post-randomisation. Results: Out of 523 individuals screened, 22 (4%) were recruited and randomised, with 20 completing their allocated group (n = 12 Simulator, n = 8 Usual Care). For those who completed training, session attendance was 100% with simulator sickness rated, on average, as mild. Six individuals (50%) in the Simulator group failed the on-road assessment, versus two (25%) in the Usual Care group (P = 0.373). On average, the Simulator group reported a positive change in confidence ratings (M = 5.77, SD = 13.96) compared to the Usual Care group, who reported a negative change (M = −6.97, SD = 8.47), P = 0.034. The Simulator group (M = 0.67, SD = 3.34) demonstrated no significant change in self-awareness relative to the Usual Care group (M = −0.83, SD = 1.83, P = 0.325). Conclusions: With adjustments to inclusion criteria and recruitment strategies, it may be feasible to deliver the intervention and conduct a larger trial. There is potential benefit of simulator training for improving driver confidence after acquired brain injury.

A Descriptive Study of the Implementation of Remote Occupational Rehabilitation Services Due to the COVID-19 Pandemic Within a Workers' Compensation Context.

Purpose The Coronavirus Disease (COVID-19) pandemic resulted in dramatic changes to avoid virus spread. In Canada, following provincial legislation the Workers’ Compensation Board of Alberta (WCB-Alberta) stopped in-person rehabilitation services on March 23, 2020. On April 1, training began on remote service delivery using videoconferencing or telerehabilitation, which started April 3. We studied WCB-Alberta’s transition to remote rehabilitation service delivery. Methods A population-based descriptive study was conducted, with data extracted from the WCB-Alberta database. This included clinical data from rehabilitation providers. We included workers completing services between January 1 and May 31, 2020. We statistically examined differences before and after the transition to remote services. Results The dataset included 4,516 individuals with work-related injuries. The mean number of work assessments per week pre-COVID was 244.6 (SD 83.5), which reduced to 135.9 (SD 74.5). Workers undergoing remote assessments were significantly more likely to work in health care or trades, did not require an interpreter, and were less likely to be working or judged as ready to return to work. Number of completed rehabilitation programs also reduced from 125.6 to 40.8 per week, with most (67.1%) remote programs being functional restoration. Few adverse effects were observed. Conclusions We describe the transition to completely remote delivery of occupational rehabilitation due to COVID-19 physical distancing restrictions in one Canadian compensation jurisdiction. It appears the use of remote services was successful but proceeded cautiously, with fewer complex cases being referred for assessment or rehabilitation. Further research examining longer-term work outcomes and stakeholder perceptions is needed.

The relation between perceived injustice and symptom severity in individuals with major depression: A cross-lagged panel study

Background: Perceived injustice has been associated with problematic recovery outcomes in individuals with debilitating health conditions. However, the relation between perceived injustice and recovery outcomes has not been previously examined in individuals with debilitating mental health conditions. The present study examined the relation between perceived injustice and symptom severity in individuals undergoing treatment for Major Depressive Disorder (MDD).Methods: The study sample consisted of 253 work-disabled individuals with MDD who were referred to an occupational rehabilitation service. Participants completed measures of depressive symptom severity, perceived injustice, catastrophic thinking, pain and occupational disability at three time-points (pre-, mid- and post-treatment) during a 10-week behavioural activation intervention.Results: Regression analysis on baseline data revealed that perceived injustice contributed significant variance to the prediction of depressive symptom severity, beyond the variance accounted for by time since diagnosis, pain severity and catastrophic thinking. Prospective analyses revealed that early treatment reductions in perceived injustice predicted late treatment reductions in depressive symptom severity.Limitations: The study sample consisted of work-disabled individuals with MDD who had been referred to an occupational rehabilitation service. This selection bias has implications for the generalizability of findings.Conclusion: The findings suggest that perceived injustice is a determinant of symptom severity in individuals with MDD. The inclusion of techniques designed to reduce perceived injustice might augment positive treatment outcomes for individuals receiving treatment for MDD.

What is the feasibility and observed effect of two implementation packages for stroke rehabilitation therapists implementing upper limb guidelines? A cluster controlled feasibility study

BackgroundHand and arm activity after stroke improves with evidence-based rehabilitation. Therapists face known barriers when providing evidence-based rehabilitation and require support to implement guidelines. The aim of this study was...

Social prescribing as an intervention for people with work-related injuries and psychosocial difficulties in Australia

Psychosocial interventions that encourage optimism and connectedness can promote workplace injury recovery and improve wellbeing. A mixed-methods evaluation of a twelve-week program for injured workers in Sydney, Australia, explored three research questions: if a social prescribing approach contributed to (1) increased social and economic participation, (2) improved psychological functioning and quality of life, and (3) decreased health service utilisation. Retrospective analysis of pre- and post-intervention data was undertaken, involving quantitative indicators of social, economic, and health status using validated psychosocial assessment tools (n = 175). These findings were augmented with data from the insurance regulator (n = 177) and insights from link worker documentation of participant activity (n = 178), a program satisfaction survey (n = 167), and participant interviews (n = 44). The social prescribing program was associated with significant improvements in frequency and confidence in participating in social activities and returning to work, in all measures of biopsychosocial wellbeing, and in reducing health service use. Qualitative information identified a range of personal improvements, including greater self-awareness, social connections, and ability to cope with the effects of injury and employment loss. This is the first known Australian study to evaluate a social prescribing intervention for psychosocial rehabilitation for injured workers in Australia. These findings suggest that a social prescribing approach is effective, but further consideration of barriers, including workplace characteristics and procedural difficulties in accessing occupational rehabilitation services, is needed.

Building a novel occupational rehabilitation program to support cancer survivors to return to health, wellness, and work in Australia.

With a substantial increase in the population of cancer survivors of working age, issues concerning sustainable employment must be addressed. The health benefits of work are well established; however, the lack of support to transition back to work is a gap in survivorship care. Researchers, occupational rehabilitation and insurance sectors, cancer support services, and consumers have collaborated to develop a tailored, multimodal occupational rehabilitation program to support resumption of meaningful work for cancer survivors. This paper describes intervention development and refinement based on pilot results and expert- and consumer-recommendations. The pilot was conducted within the life insurance sector, a collaboration fostered by global reinsurance company Swiss Re, with cancer survivors referred to an Australian provider of occupational rehabilitation services. Preliminary outcomes from 15 of 72 cancer survivors following adequate engagement (excluding those who withdrew or were still actively engaged) showed 10 (67%) with improved certified capacity to work, translating to 13 (87%) with improved work status. Consultant survey results indicated barriers to participation in and engagement with the program, including referral delays, health concerns, and cancer recurrence. Expert panel recommendations were used to refine the intervention and tailor to breast cancer survivors for the feasibility stage. Strengths include an innovative model of referral and funding, through a life insurance provider, the involvement of a multidisciplinary collaborative team to design, develop and implement the pilot, and considerable consumer involvement. The refined intervention will address a critical gap to improve reintegration into work and society, contributing to improved quality of life for cancer survivors in Australia. Models of referral through insurers to rehabilitation services could be adopted in other jurisdictions.

Toplumsal Katılım ve Ergoterapi

Katılım kavramı, son yıllarda ergoterapi, rehabilitasyon ve sağlık hizmetlerinde merkezi bir kavram haline gelmiştir. Katılım, ergoterapi müdahalelerinin nihai hedefi ve sonucudur. Ergoterapistler bireyler, gruplar veya topluluklarla işbirliği içerisinde çalışarak, aktiviteler yoluyla katılımı artırmayı hedeflerler. Bireyin yetenekleri, aktivitelerin özellikleri, bağlam ve çevrenin, katılımı destekleyici ya da kısıtlayıcı rol oynayabilir. Ergoterapi uygulamaları, sağlık durumu nedeniyle vücut yapı ve fonksiyonlarında bozukluğu olan, katılım kısıtlılığı yaşayan ya da sosyal veya kültürel azınlık gruplarda olduğu için dışlanan tüm bireylere yönelik olarak, ev, okul, iş yerleri, sağlık merkezleri, huzurevleri, rehabilitasyon merkezleri, hastaneler ve adli merkezler gibi çok çeşitli toplumsal alanlarda gerçekleştirilir. Bu derlemede, ergoterapi, toplum ve katılım kavramları, Dünya Sağlık Örgütü’nün katılıma bakışı, toplumsal katılımda ergoterapistlerin rol ve sorumlulukları, çocuk, yetişkin ve yaşlı engelli bireylerde toplumsal katılım konularına yer verilmiştir.

Low vision rehabilitation services: Perceived barriers and facilitators to access for older adults with visual impairment

Introduction The aim of this study is to describe the barriers and facilitators to accessing low vision rehabilitation services in Massachusetts, USA, and determine differences between communities with and without existing low vision rehabilitation services for older adults with visual impairment. Method A sample of older adults with visual impairment ( n = 64) from both communities participated in the study. Barriers and facilitators to accessing the services were explored through focus groups and prioritized during one-on-one interviews, which allowed for comparison between communities. Results Twelve themes were identified: (a) bureaucracy and funding (public policy); (b) public awareness and stigma (community); (c) services available, knowledge of providers, care coordination, transportation (organizational); (d) people and lack of awareness of family/friends (interpersonal); and (e) income, health status, knowledge, self-advocacy, and time (individual). Conclusion This study provides insights into the perceived barriers and facilitators of accessing low vision rehabilitation services for older adults with vision impairment living in Massachusetts, USA. Key findings indicate the need for improved awareness of these services at the provider and consumer level, coordinated care, increased education on the efficacy of occupational therapy low vision rehabilitation services, client-centered care provided when the client is ready to accept services, and service provision that addresses sociodemographic factors.

Employee Recognition on Individual Support Plan(ISP) of the Developmental Disability Support Center

본 연구는 발달장애인지원센터의 개인별지원계획 업무를 수행하는 종사자의 인식연구를 통해 개인별지원계획현황, 적정성과 성과에 영향을 미치는 요인을 알아보는데 목적이 있다. 본 연구를 위해 전국 17개 시도에 설치된 지역발달장애인지원센터 중 개인별지원팀장을 포함한 팀원을 대상으로 전수조사를 실시하였으며 분석결과는 다음과 같다. 첫째, 개인별지원계획 신청자는 남성이 많았으며, 연령은 20대, 장애는 지적장애가 높게 나타났다. 둘째, 개인별지원계획 욕구로는 고용 관련 욕구가 가장 높았고 다음으로 여가활동과 공적급여 형태의 경제적 욕구 등이 높게 나타났다. 개인별지원계획 수립시 어려움으로는 연계서비스의 부족이 가장 높게 나타났고 다음으로 지자체 및 복지서비스 기관 등의 사회적 인식부족, 다음으로 복잡한 수행절차가 높은 순으로 나타났다. 셋째, 개인별지원계획의 적정성과 성과에 영향을 미치는 요인으로는 담당자 직무교육실시를 통해 받는 도움의 정도가 중요하게 나타나 정기적인 교육과 보수교육 등의 지속적 교육이 필요한 것으로 나타났다. 결론적으로 발달장애인을 위한 개인별지원계획이 정착되기 위해서는 중앙발달장애인지원센터 차원에서의 정기적이고 표준화된 교육개설을 통해 종사자의 전문성 확보를 위한 지원이 중요함을 시사하고 있었다.This study was designed to conduct focused on Individual support plan which is the most fundamental work among various businesses such as Individual support plan, Public guardian support business, Right remedy support and so on operated by Developmental disability support center. It aimed to investigate the effect of factor on result, Individual support plan status and suitability throughout the study on employee recognition who performed Individual support plan. The complete survey was taken for employees including individual support managers of regional developmental disability support centers in the 17-provinces in Korea and the results were as follows as. First, applicant on Individual support plan service was male mostly in Individual support plan status, the age group was in one’s 20’s, intellectual disability rate was high. Second, their main need to apply for Individual support plan was highly related to employment, and the public service was highly relevant to the disabled activity support in the public and private service. The occupational rehabilitation service provided economic opportunities and income support in private service held on important place. Third, in point of the correlation and regression analysis implemented to check how Individual support plan affect the performance and appropriateness, the more they are supported by a common education and sectional education, the more they are influenced by appropriateness and performance. Considering the business is only just started, it is necessary to be supported in order to progress the business smoothly via regular education and refresher training. In conclusion, this article involved the importance of support for specialty reinforcement of employees through regular and standardized on-the-job education.

Perceptions of workforce managers about the role and responsibilities of physiotherapists in occupational health rehabilitation: A qualitative study

Introduction: It is imperative that occupational health physiotherapists understand their roles and responsibilities from the perceptions of workforce managers who are responsible for commissioning their services in order to ensure that previously unknown physiotherapy needs can be surfaced and known needs can be improved and refined. Aim: The aim of the study was therefore to explore the perceptions of workforce managers involved in commissioning occupational health rehabilitation services about the role and responsibilities of physiotherapists providing these services. Methods: The study incorporated a qualitative framework underpinned by an interpretive construct. Five workforce managers who were involved in the commissioning of occupational health rehabilitation services were interviewed. Data were collected via semi-structured interviews and analyzed using thematic content analysis. Results: Several themes and sub-categories about the role and responsibilities of occupational health physiotherapy were identified. The findings highlighted the complex nature about the role of physiotherapists providing occupational health rehabilitation services. Conclusions: In summary, to establish a role for occupational health physiotherapists based solely on clinical skills would fundamentally devalue the role because it became apparent that physiotherapists were perceived as providing a varied role with numerous responsibilities within occupational health rehabilitation services.

Return-to-work intervention during cancer treatment - The providers' experiences.

To explore in-depth understanding of providers' experiences when involved in a return-to-work (RTW) intervention offered during cancer treatment. Semi-structured individual interviews and participant observations at a hospital department and two municipal job centers were carried out, including ten providers (physicians, nurses and social workers). A phenomenological-hermeneutic approach was applied, involving coding, identification of themes and interpretation of findings. Three major themes were identified: Treatment first, Work as an integrated component in cancer rehabilitation, and Challenges in bringing up work issues. Differences in providers' experiences of the RTW intervention offered to cancer patients were found: in the hospital setting RTW was a second priority, whereas in the municipality job centers it was an integrated component. Further studies are needed to investigate how and when occupational rehabilitation services can be implemented across sectors to support cancer patients' RTW. In the future, work issues ought to be systematically presented by providers across sectors as early as possible to support cancer patients' RTW. Cancer patients' individual needs and thoughts about RTW are to be identified by both health care providers during treatment and social workers at the municipality level and shared across sectors.

Treatment‐related reductions in catastrophizing predict return to work in individuals with post‐traumatic stress disorder

AbstractPost‐traumatic stress disorder (PTSD) has been associated with high rates of work‐disability. In other domains of research, it has been shown that catastrophic thinking also contributes to work‐disability. The present study examined the relation between catastrophic thinking and work‐disability in individuals with PTSD. The study sample consisted of 73 work‐disabled individuals with PTSD who were referred to an occupational rehabilitation service. Participants completed measures of post‐traumatic stress symptoms, depression, pain, catastrophic thinking, and occupational disability at admission and termination of the rehabilitation intervention. Return‐to‐work was assessed 1 month following the termination of the rehabilitation intervention. Cross‐sectional analyses revealed that catastrophic thinking contributed significant unique variance to the prediction of occupational disability, even when controlling for the severity of symptoms of PTSD. Prospective analyses revealed that treatment‐related reductions in catastrophic thinking predicted successful return to work, beyond the variance accounted for by reductions in the severity of symptoms of PTSD. The findings suggest that catastrophic thinking is a determinant of occupational disability in individuals with PTSD. The findings further suggest that interventions designed to reduce catastrophic thinking might promote more successful occupational re‐integration in individuals recovering from post‐traumatic stress symptoms.

Perceptions of workforce managers about the role and responsibilities of physiotherapists in occupational health rehabilitation: A qualitative study

Introduction: It is imperative that occupational health physiotherapists understand their role and responsibilities from the perceptions of workforce managers who are responsible for commissioning their services in order to ensure that previously unknown physiotherapy needs can be surfaced and known needs can be improved and refined. Aim: The aim of the study was therefore to explore the perceptions of workforce managers involved in commissioning occupational health rehabilitation services about the role and responsibilities of physiotherapists providing these services. Methods: The study incorporated a qualitative framework underpinned by an interpretive construct. Five workforce managers who were involved in the commissioning of occupational health rehabilitation services were interviewed. Data were collected via semi-structured interviews and analysed using thematic content analysis. Results: Several themes and sub-categories about the role and responsibilities of occupational health physiotherapy were identified. The findings highlighted the complex nature about the role of physiotherapists providing occupational health rehabilitation services. Conclusions: In summary, to establish a role for occupational health physiotherapists based solely on clinical skills would fundamentally devalue the role because it became apparent that physiotherapists were perceived as providing a varied role with numerous responsibilities within occupational health rehabilitation services.