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Emphasize Function Over Feeling in Chronic Illness
Published in Scott A. Simpson, Anna K. McDowell, The Clinical Interview, 2019
Scott A. Simpson, Anna K. McDowell
A more productive and rewarding approach is to orient the history and treatment around the patient’s functioning.3 Pain is the perception of tissue damage—a perception that is inaccurate among many patients whose pain has become chronic. For these patients there may be no underlying tissue damage, and pain is a complex phenomenon representing abnormalities of neurologic transmission, sensation sensitivity, and cognitive distortions around the meaning of pain. The treatment approach must be accordingly more complex and incorporate non-pharmacologic and physical therapies and occupational rehabilitation.
Work and health: what direction for occupational health practice?
Published in Siân Griffiths, Davide J Hunter, Sir Kenneth Calman, New Perspectives in Public Health, 2017
At this point we see the separation of treatment services of all types from other healthcare provision. From the occupational health point of view, the NHS was not going to concern itself with the prevention of occupational disease, nor in large measure would it concern itself with returning ill or injured workers back to work – occupational rehabilitation. It would treat illness and injury such as lung disease, skin disease and back pain – whether caused occupationally or not – but the other matters such as prevention or occupational rehabilitation were rigorously excluded from its purview.
Vocational and Occupational Rehabilitation for People with Brain Injury
Published in Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth, Neuropsychological Rehabilitation, 2017
Andy Tyerman, Mick Meehan, Ruth Tyerman
Vocational rehabilitation (VR) is the overall process of ‘enabling individuals with either temporary or permanent disability to access, return to, or to remain in employment’ (BSRM, 2000, p. 11). This process is also referred to as occupational rehabilitation or work rehabilitation. In this chapter VR refers broadly to the process of assisting people to enter, return to and/or remain in employment, education/training or alternative occupation (e.g. voluntary work or family carer).
Impact of robotics and human enhancement on occupation: what does it mean for rehabilitation?
Published in Disability and Rehabilitation, 2020
Manel Djebrouni, Gregor Wolbring
Various professions and discourses engage with the area of “occupation.” Occupational health and safety professions and discourses emphasize “occupation” in terms of paid work and employment and how to prevent injury and promote safety [18]. Occupational rehabilitation professionals are involved in back-to-work aspects such as “employee hiring, placement and retention, employee safety and injury avoidance and, for more severely disabled individuals, vocational rehabilitation and benefits entitlement” [19]. Occupational medicine/occupational physicians work on the nexus between work and health [20]. Occupational science and occupational therapy expand the term occupation [21] into “the things that people do (their occupations)” [21, p.1]. It is “all the things that people need, want or have to do” [22, p.xiv]. Hence doing, being, belonging and becoming are four important aspects of occupations of daily life [23]. According to the Canadian Society of Occupational Scientists, some questions about occupation in occupational science are about the very meaning of occupation including the dynamics that influence which occupations are valued or not and how people become occupied [24].
Transdiagnostic group-based occupational rehabilitation for participants with chronic pain, chronic fatigue and common mental disorders. A feasibility study
Published in Disability and Rehabilitation, 2018
Karen Walseth Hara, Petter Christian Borchgrevink, Henrik Børsting Jacobsen, Marius Steiro Fimland, Marit By Rise, Sigmund Gismervik, Astrid Woodhouse
Occupational rehabilitation is a highly relevant area for transdiagnostic therapy since the aim is not primarily to reduce symptoms or cure a specific disease but rather to improve work ability, a goal that carries commonality across diagnoses. Crossover between occupational rehabilitation programs for mental and somatic disorders has not been adequately operationalized and investigated in a systematic manner. Treatment strategies that take into account comorbidity are advised [14,31] and transdiagnostic programs are already emerging within occupational rehabilitation [32] Still, some stakeholders voice anxiety about departing from more familiar diagnose-specific rehabilitation. Decision makers need knowledge on the feasibility of implementing transdiagnostic rehabilitation programs and their acceptability to participants. This paper explores key uncertainties in the design of transdiagnostic group-based occupational rehabilitation while adhering to the call for practice-based evidence [33], research on heterogeneous populations [34], early phase evaluation of complex interventions [35–37] and exploring feasibility through mixed methods [11].
Is there really a “golden hour” for work disability interventions? A narrative review
Published in Disability and Rehabilitation, 2020
Lene Aasdahl, Marius Steiro Fimland
In summary, the current literature lends some support to the suggestion that the subacute phase of sick leave is a beneficial time to start occupational rehabilitation for workers sick listed due to musculoskeletal complaints. However, recent studies suggest that occupational rehabilitation also can be very effective for people with longer sick leave durations. Our interpretation is that it is more relevant to consider what to offer when. In the subacute phase of sick leave, both simple and more complex multidisciplinary interventions have been successful. From a resource-perspective, it seems sensible to start with simpler low-cost interventions before considering interventions that are more comprehensive. This type of stepped-care approach would also reduce excessive treatment, which can prolong sick leave. However, where the cutoff between simple and complex interventions should be is not clear, and more research is needed. It is also a question about who needs what kind of treatment, and more work is needed to find good prognostic tools that are clinically useful. In addition, brief interventions, which have been shown to be effective in the subacute phase of sick leave due to low back pain, should be evaluated for other conditions as well (e.g., mental disorders). Future research should focus on stepped-care approaches to develop appropriate measures at different phases of sick leave and prognostic tools to early identify sick listed workers who need interventions that are more complex. Finally, more-high quality studies are needed on the effect of occupational rehabilitation for sick listed individuals with mental health complaints.