Abstract
Background: This is a clinical randomized trail (RCT) to investigate the effects of a three-week training program on work readiness designed for musculoskeletal injured workers with long-term sick leave who had difficulties resuming their work role. The program was planned to help injured workers overcome the psychological and psychosocial problems and to facilitate their Work Readiness on Return to Work (RTW) based on the Employment readiness model. Methodology: A total of 64 injured workers were recruited and randomly assigned into the training (T) and control (C) groups. Observations were blinded between service providers and evaluators. A three-week intensive training on work readiness program was given to the T group while subjects in the C group were given advice on job placement by social workers in a community work health center. The training program was comprised of individual vocational counseling and group therapy using cognitive behavioral approach to alleviate symptoms of stress, pain and anxiety. The Chinese Lam Assessment of Stages of Employment Readiness (C-LASER), the Chinese State Trait and Anxiety Inventory (C-STAI) and the Short form of Health Survey (SF-36) were used to evaluate all subjects’ psychological health status and behavioral changes on job readiness before and after the intervention. Results: Subjects in the T group showed significant improvement in their work readiness (p < 0.05), level of anxiety (p < 0.05) and their self perception of health status measured by SF-36 (p < 0.02) when compared with subjects in the C group. Control of chronic pain, negative motivation, and anxiety level were some of the key behavioral changes found from the study. Conclusion: The TWR program appeared to improve injured workers’ motivation and employment readiness. Further study on the employment outcomes of subjects is recommended.
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Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol 2004;14:13–23.
National Research Council and Institute of Medicine. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities. Washington, DC: National Academy Press; 2001.
Baldwin ML. Reducing the costs of work-related musculoskeletal disorders: targeting strategies to chronic disability cases. J Electromyogr Kinesiol 2004;14:33–41.
Labour Department. Labour Department Annual Report. Hong Kong: HKSAR; 2003.
Baker P, Goodman G, Ekelman B, Bonder B. The effectiveness of a comprehensive work hardening program as measured by lifting capacity, pain scales, and depression scores. Work 2005;24:21–31.
Waddell G. A new clinical model for the treatment of low-back pain. Spine 1987;12:632–44.
Waddell G. Biopsychosocial analysis of low back pain. Clin Rheumatol 1992;6:523–57.
Feuerstein M, Burrell LM, Miller VI, Lincoln A, Huang GD, Berger R. Clinical management of carpal tunnel syndrome: A 12-year review of outcomes. Am J Ind Med 1999;35:232–45.
Watson PJ, Booker CK, Moores L, Main CJ. Returning the chronically unemployed with low back pain to employment. Eur J Pain 2004;8:359–69.
Nachemson AL, Spengler DM, Fisher LD, et al. A prospective study of work perceptions and psychosocial factors affecting the report of back injury. Spine 1991;16:1–6.
Adams JH, Williams ACC. What affects return to work for graduates of a pain management program with chronic upper limb pain? J Occup Rehabil 2003;13:91–106.
Franche RL, Krause N. Readiness for return to work following injury or illness: conceptualizing the interpersonal impact of health care, workplace, and insurance factors. J Occup Rehabil 2002;12:233–56.
Berglind H, Gerner U. Motivation and return to work among the long-term sicklisted: an action theory perspective. Disabil Rehabil 2002;24:719–26.
Cheng JKC, Li-Tsang WPC. A comparison of self-perceived physical and psycho-social worker profiles of people with direct work injury, chronic low back pain, and cumulative trauma. Work 2005;25:315–23.
Tulder MW, Ostelo R, Vlaeyen JWS, Linton SJ, Morley SJ, Assendelft WJJ. Behavioral treatment for chronic low back pain, a systematic review within the framework of the Cochrane back review group. Spine 2000;26:270–81.
Marhold C, Linton SJ, Melin L. A cognitive-behavioral return-to-work program: Effects on pain patients with a history of long-term versus short-term sick leave. Pain 2001;91:155–63.
Oleske DM, Anderson GBJ, Lavender SA, Hahn JJ. Association between recovery outcomes for work-related low back disorders and personal, family, and work factors. Spine 2000;25:1259–65.
Burton AK, Battie MC, Main CJ. The relative importance of biomechanical and psychosocial factors in low back injuries. In: Karwowski W, Marras WS, eds. Occupational Ergonomics Handbook. Boca Raton, Fla.: CRC Press; 1999:1127–38.
Prochaska J, DiClemente C, Norcross J. In search of how people change: applications to addictive behaviors. Am Psychol 1992;47:1102–14.
John C, Prochaska J. Using the Stages of Change. Harv Ment Health Lett 2002;5:5–8.
Adams JH, Williams AC. What affects return to work for graduates of a pain management program with chronic upper limb pain? J Occup Rehabil 2003;13:97–106.
Jensen MP, Romano JM, Turner JA, Good AB, Wald LH. Patient beliefs predict patient functioning: further support for a cognitive-behavioral model of chronic pain. Pain 1999;81:95–104.
Chan CHC, Li-Tsang WPC, Hung LK, Lam CWP. A standardized clinical series for work-related lateral epicondylitis. J Occup Rehabil 2000;10:143–52.
Cheung YL, Molassiotis A, Chang AM. A pilot study on the effect of progressive muscle relaxation training of patients after stoma surgery. Eur J Cancer Care 2001;10:107–14.
Tsoi MM, Ho E, Mak KC. Becoming pregnant again after still birth or the birth of a handicapped child. In: Dennerstein L, Fraser I, eds. Hormones and Behavior. Netherlands: Elsevier Science; 1986:310–16.
Shek DT. Reliability and factorial structure of the Chinese version of the State-Trait Anxiety Questionnaire. J Psychopathology Behav Assess 1988;10:303–17.
Flores S, Gatchel RJ, Polatin PB. Objectification of functional improvement after nonoperative care. Spine 1997;22:1622–33.
Ware JE. SF-36 health survey update. Spine 2000;25:3130–39.
Atroshi1 I, Anderson IH, Gummesson C, Leden I, Odenbring S, Ornstein E. Primary care patients with musculoskeletal pain value of health-status and sense-of-coherence measures in predicting long-term work disability. Scand J Rheumatol 2002;31:239–44.
Gatchel RJ, Polatin PB, Mayer TG, Robinson R, Dersh J. Use of the SF-36 health status survey with a chronically disabled back pain population: strengths and limitations. J Occup Rehabil 1998;8:237–46.
Gatchel RJ, Mayer T, Dersh J, Robinson R, Polatin P. The association of the SF-36 health status survey with 1-year socioeconomic outcomes in a chronically disabled spinal disorder population. Spine 1999;24:2162–70.
Tufescu TV, Buckley R. Age, gender, work capability, and worker's compensation in patients with displaced intraarticular calcaneal fractures. J Orthop Trauma 2001;15:75–279.
Feuerstein M. A multidisciplinary approach to the prevention, evaluation, and management of work disability. J Occup Rehabil 1991;1:5–12.
Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain 2000;85:317–32.
Calfas KJ, Long BJ, Sallis JF, Wooten WJ, Pratt M, Patrick K. A controlled trial of physical counseling to promote the adoption of physical activity. Prev Med 1996;26:225–33.
Bock BC, Marcus BH, Pinto BM. Maintenance of physical activity following an individualized motivationally tailored intervention. Ann Behav Med 2001;23:79–87.
Allaire SH, Niu J, LaValley MP. Employment and satisfaction outcomes from a job retention intervention delivered to persons with chronic diseases. Rehabil Couns Bull 2005;48:100–9.
Turk DC, Meichenbaum DH, Genest M. Pain and Behavioral Medicine: Theory, Research, and Clinical Guide. New York: Guilford; 1983.
Linton SJ, Anderson T. Can chronic disability be prevented? A randomized trial of a cognitive-behavioral intervention and two forms of information for patients with spinal pain. Spine 2000;25:2825–31.
LeFort SM, Donald KG, Rowat KM, Jeans ME. Randomized controlled trial of a community-based psycho education program for the self-management of chronic pain. Pain 1998;74:297–306.
Arutaa T, Malinchoc M, Offord KP, Colligan RC. Status of patients with chronic pain 13 years after treatment in a pain management center. Pain 1998;74:199–204.
Acknowledgments
The authors would like to acknowledge all the workers who had kindly agreed to participate in this research study. Special thanks to the two funding bodies, The Institute for Enterprise (IfE), Hong Kong Polytechnic University and the Hong Kong Workers’ Health Center under the Teaching Company Scheme. Finally, the authors would also like to thank Mr. Henky Chan and colleagues from the Hong Kong Workers’ Health Center for their contribution to this project.
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Li, E.J.Q., Li-Tsang, C.W.P., Lam, C.S. et al. The effect of a “training on work readiness” program for workers with musculoskeletal injuries: A randomized control trial (RCT) study. J Occup Rehabil 16, 529–541 (2006). https://doi.org/10.1007/s10926-006-9034-3
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DOI: https://doi.org/10.1007/s10926-006-9034-3