Assignment: Literature Review about Feasibility Study

Assignment: Literature Review about Feasibility Study ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Literature Review about Feasibility Study I’m studying for my Management class and don’t understand how to answer this. Can you help me study? Assignment: Literature Review about Feasibility Study Can you assist me with writing a 3-4 page literature review on the following article? Please feel free to add additional information on the subject. feasability_study__group_4.pdf J Occup Rehabil (2009) 19:212–222 DOI 10.1007/s10926-009-9170-7 A Participatory Workplace Intervention for Employees With Distress and Lost Time: A Feasibility Evaluation Within a Randomized Controlled Trial Sandra H. van Oostrom Æ Willem van Mechelen Æ Berend Terluin Æ Henrica C. W. de Vet Æ Johannes R. Anema Published online: 24 March 2009 ! The Author(s) 2009. This article is published with open access at Springerlink.com Abstract Introduction Little is known about feasibility and acceptability of return to work (RTW) interventions for mental health problems. RTW for mental health problems is more complicated than for musculoskeletal problems due to stigmatization at the workplace. A participatory workplace intervention was developed in which an employee and supervisor identify and prioritize obstacles and solutions for RTW guided by a RTW coordinator. This paper is a feasibility study of this innovative intervention for employees with distress. The aims of this study were to describe the reach and extent of implementation of the workplace intervention, the satisfaction and expectations of all stakeholders, and the intention to use the workplace intervention in the future. Methods Eligible for this study were employees who S. H. van Oostrom ! W. van Mechelen ! J. R. Anema (&) Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands e-mail: [email protected] S. H. van Oostrom ! W. van Mechelen ! J. R. Anema [email protected], Research Center Physical Activity, Work and Health, TNO-VU University, Amsterdam, The Netherlands W. van Mechelen ! J. R. Anema Research Center for Insurance Medicine AMC-UWV-VU University Medical Center, Amsterdam, The Netherlands B. Terluin Department of General Practice and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands H. C. W. de Vet Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands 123 had been on sick leave from regular work for 2–8 weeks with distress. Data were collected from the employees, their supervisors, RTW coordinators, and occupational physicians by means of standardized matrices and questionnaires at baseline and 3 months follow-up. Reach, implementation, satisfaction, expectations, and maintenance regarding the workplace intervention were described. Results Of the 56 employees with distress eligible to receive the workplace intervention, 40 employees, their supervisors and RTW coordinators actually participated in the intervention. They identified 151 obstacles for RTW mostly related to job design, communication, mental workload and person-related stress factors. The 281 consensus-based solutions identified were mostly related to job design, communication and training. Of those solutions, 72% was realized at the evaluation with the employee and supervisor. Overall, employees, supervisors and occupational health professionals were satisfied with the workplace intervention and occupational health professionals rated it with a 7.1. Timeinvestment was the only barrier for implementation reported by the occupational health professionals. Conclusions The results of this study indicate a high feasibility for a broad implementation of a participatory workplace intervention for employees with distress and lost time, and their supervisors. Keywords Distress ! Workplace intervention ! Feasibility ! Return to work ! Implementation ! Mental health Abbreviations RCT Randomized controlled trial OH Occupational health RTW Return to work J Occup Rehabil (2009) 19:212–222 LBP OP Low back pain Occupational physician Introduction Many randomized controlled trials (RCTs) have been conducted in the field of occupational health (OH), but in general, those trials provide little information about the content and degree of implementation of the interventions in question [1, 2]. However, the implementation and feasibility aspects of interventions are of critical importance, since they address the issue of how easily an intervention can be implemented in practice and how well the intervention is received. This information makes it possible for care providers and researchers to determine whether the findings of a study apply to their local setting, population and country [3]. These are important aspects in view of the difficulties that are encountered when transferring evidence into practice [4], also in mental health [5]. In fact, an intervention has to be both effective and feasible. Effective interventions that are not feasible to be implemented are useless in practice, and the same applies to interventions that are feasible to be implemented but lack effectiveness. The need for knowledge about the implementation and feasibility of an intervention has been recognized by many authors since the beginning of this decade [6, 7]. However, the number of feasibility studies alongside RCTs in the field of occupational health is very limited [1, 8, 9]. The present paper is a feasibility study of a participatory workplace intervention for sick-listed employees with distress. The workplace intervention is a stepwise process to identify and solve obstacles for return to work (RTW), based on consensus between a sick-listed employee and his or her supervisor. The participatory workplace intervention is an innovative approach in mental health. Evidence shows that medical interventions without consideration of the work situation do not show a positive effect on RTW outcomes [10, 11].Assignment: Literature Review about Feasibility Study A return to an unchanged work situation of an employee with mental health problems may be doomed to fail and may even lead to longer-term recurrences [12, 13]. Therefore, it is recommended that RTW interventions should be carried out close to the workplace and in collaboration with the key stakeholders [1, 14]. The workplace intervention was based on a successful RTW intervention for sick-listed employees with low back pain (LBP) [15, 16], and was further tailored to the needs of sick-listed employees with distress by applying the Intervention Mapping approach [17]. Due to stigmatization at the workplace RTW of employees with distress is more complicated than for musculoskeletal problems [18]. The 213 feasibility and implementation of an intervention are factors to be considered as part of the evaluation in Intervention Mapping [19]. Through small-scale consideration of these aspects, factors that impede large-scale implementation can be identified and, if necessary, improved to facilitate a largescale implementation. The aims of this study were (1) to describe the reach of the workplace intervention; (2) to describe whether the workplace intervention was implemented as planned, including a description of perceived barriers for implementation; (3) to describe the satisfaction and expectations of employees, supervisors, and OH professionals; and (4) to describe whether OH professionals reported the intention to use the workplace intervention in the future. Methods This feasibility study was carried out as part of a RCT on the effectiveness of a participatory workplace intervention for sick-listed employees with distress, the ADAPT study [20]. The Medical Ethics Committee of the VU University Medical Center approved the study and all participants signed informed consent. Study Population Eligible for this study were employees who had been on sick leave from regular work for 2–8 weeks with distress, and were selected by a three-item distress screener based on the four-dimensional symptom questionnaire (4DSQ) [20, 21]. The distress screener correlated high (0.82) with the 4DSQ distress scale. Sensitivity and specificity of the distress screener were, respectively, 0.85 and 0.78 [22]. The study population encompassed both criteria-based psychiatric disorders (mostly depressive and anxiety disorders) and ‘subthreshold’ disorders (including adjustment disorders). It is generally known that distress can coexist with chronic diseases and/or physical symptoms, therefore a group of distressed participants with heterogeneous health conditions was selected. Exclusion of employees occurred in case of (1) a conflict between the employee and the employer with legal involvement; (2) working less than 12 h a week; (3) pregnancy; (4) sick-listed for more than 8 weeks; (5) another episode of sick leave within 1 month before the current episode; and (6) inability to complete questionnaires written in the Dutch language. Occupational physicians (OPs) excluded employees with severe psychiatric disorders (mania, psychosis or suicidal) or a terminal illness from starting the workplace intervention. The Improved Gatekeeper’s Act mandates the employer to formulate a plan for RTW with the employee at 8 weeks of sick leave. If this plan is formulated, it is more difficult to initiate other interventions. 123 214 This paper focussed on the first 40 participants who had actually started to participate in the workplace intervention, which means that only part of the recruitment sample was considered. J Occup Rehabil (2009) 19:212–222 were partly based on RE-AIM, a framework that recognizes several objectives for the evaluation of interventions [23]. Effectiveness of the workplace intervention was not assessed in this feasibility study, these results will become available in the near future. Workplace Intervention Reach The workplace intervention consisted of a stepwise process to identify and solve obstacles for RTW, based on consensus between the sick-listed employee and his or her supervisor. The intervention was guided by a RTW coordinator from the respective occupational health services, i.e., a company social worker or a labour expert. In the Netherlands, a labour expert is a specialist in occupational health and work processes who helps sick-listed employees to RTW. Assignment: Literature Review about Feasibility Study Although, the RTW coordinators were employed by private occupational health services, they are indirectly paid by employers. However, Dutch regulations guarantee the independency of the RTW coordinators. The RTW coordinator planned three meetings on 1 day. In the first meeting, the employee performed a task analysis and identified obstacles for RTW in a structured conversation with the RTW coordinator. These obstacles were ranked according to priority, based on their frequency and perceived severity. In the second meeting, the supervisor identified obstacles for RTW from the perspective of the supervisor. The procedure of the meeting between the supervisor and the RTW coordinator was the same as in the meeting between the employee and the RTW coordinator. In the third meeting, the employee, the supervisor and the RTW coordinator were jointly involved in brainstorming for solutions. The solutions were ranked according to priority, based on feasibility, solving capability and short-term applicability of the suggested solution. Then a plan for realization of the suggested solutions was formulated, including the person responsible for the realization, how the solution was planned, and when it should be realized. This plan was based on consensus. In the weeks following the meetings the solutions could be realized. If required, an RTW coordinator planned a visit to the workplace to instruct and advise the employee. One month after the meetings, actual realization of the solutions and contributions to RTW were evaluated by the RTW coordinator with the employee and the supervisor. This workplace intervention has been described in detail in other papers [15, 20]. Fig. 1 presents an example of the application of the workplace intervention. Data Collection The data for this study were collected by questionnaires (at baseline, at the 3 month follow-up, and when all 40 workplace interventions had been completed) and standardized matrices (as shown in Fig. 1). The concepts used 123 Reach was addressed at setting level and at participants’ level. At setting level, reach is defined as the number of settings and the representativeness of the settings (companies and OH professionals) participating in the research. At participants’ level, reach is defined as the number of employees and the representativeness of the employees who participated in the research. Reasons for non-participation were registered. All participants completed a baseline questionnaire, providing demographic information, information about symptom severity, and job characteristics. Implementation of the Workplace Intervention Implementation concerns the extent to which the intervention was provided as intended (i.e., as described in the intervention manual) [23]. Complete implementation of the workplace intervention was achieved if the three meetings between the RTW coordinator, employee and supervisor had actually taken place and if the standardized matrices had been accurately completed by the RTW coordinators. The number of employees who did not actually participate in the workplace intervention and the reasons given were registered. At the 3 month follow-up, an intervention evaluation questionnaire was sent to the employee, the supervisor, and the OH professionals (i.e., the RTW coordinator and the OP). The questions concerned the intervention process, the satisfaction with the intervention, the work adaptations that were selected, and the perceived effect of these work adaptations. Assignment: Literature Review about Feasibility Study The RTW coordinators also provided data about the timing and duration of the intervention and these were compared with the intervention manual. Information concerning obstacles for RTW, solutions and the RTW plan discussed in the meetings was collected on the standardized matrices, which were completed by the RTW coordinator, based on the agreements made during the meetings. All obstacles and solutions for RTW were classified based on the ergonomic abstracts classification scheme and the definition of work organization in the National Occupational Research Agenda of the National Institute for Occupational Safety and Health [15, 24, 25]. The classification categories were: workplace design; work design and organization (tasks, schedules, communication, training, management style, use of support, organizational characteristics); environment; and task-related factors J Occup Rehabil (2009) 19:212–222 Fig. 1 Case description 215 Mr. B, 42 years old, is an experienced and motivated worker. He works in an administrative job in a financial department since 1999. His main task is the processing of invoices into the computer. Because of his experience and his knowledge of the department, colleagues frequently ask him to help them with other tasks. Since February 2007, everyone in the department had become busier, due to an increase in the number of invoices. A pile of invoices was usually lying on Mr. B’s desk waiting to be processed. After a period of increased workload, Mr. B was no longer able to carry out his work, and he took sick leave in August 2007. His OP diagnosed an adjustment disorder. Mr. B had extreme fatigue, and suffered from sleeplessness and concentration problems. After 3 weeks of sick leave the OP referred Mr. B to the workplace intervention. The RTW coordinator (Ms. G) contacted Mr. B and his supervisor (Ms. T) to plan the meetings for the workplace intervention. • In the first meeting, Mr. B and Ms. G performed a task analysis, identified obstacles for RTW, and prioritised the most important obstacles. • In the second meeting, Ms. T and Ms. G identified obstacles for RTW from the supervisor’s perspective and prioritised the most important obstacles. • In the third meeting, Mr. B, Ms. T and Ms. G brainstormed to find solutions for the prioritised obstacles, selected the most appropriate solutions, and made agreements about what should be done, by whom and when. Part of the matrices completed by the RTW coordinator are presented below. One week after the three intervention meetings Mr. B started a gradual RTW in his own job (after consultation with the OP). Matrix: obstacles for RTW Name worker: Mr. B Name supervisor: Ms. T Name RTW coordinator: Ms. G Date: 20-09-2007 Main tasks Activities Obstacle Frequency Severity Priority Processing of invoices Arranging invoices High workload due to pile of invoices **** *** 1 Putting invoices into the computer Concentration problems (too much invoices, very accurate work) *** *** Assignment: Literature Review about Feasibility Study 4 Time consuming, less time for own work *** *** 3 Difficulties with delegation of tasks ** *** 2 Archiving invoices Helping colleagues with difficult invoices Giving advice to colleagues Organizing weekly meetings about distribution of work Preparing meetings Chairing meetings Frequency: report if a certain task occurs frequently or not: * = only once in a while (for instance once a week or month) ** = on a regular basis (for instance a few times a week, sometimes once a day) *** = often (more times a day) **** = always (every hour of the day) Severity: report the severity of every obstacle: * = somewhat severe ** = severe *** = very severe (mental workload, physical workload, person-related stress). When all 40 workplace interventions had been completed, an implementation questionnaire focussing on barriers and facilitators for implementation of the intervention was sent to all OPs and RTW coordinators [26, 27]. measured with the short version of the Patient Satisfaction with Occupational Health Services Questionnaire [28], which consists of a five-point scale ranging from no agreement to full agreement. Satisfaction, Usefulness and Expectations Maintenance is defined as the intention of OH professionals to support the implementation of the workplace intervention in the future. Actual maintenance could not be measured because large-scale implementation was not the purpose of this study. Therefore, questions were asked about intentions for future use in the implementation questionnaire for OH professionals. This questionnaire also included questions about the OH professionals’ view on the Satisfaction after participation in the workplace intervention, perceived usefulness of the intervention and expectations for RTW (and symptom recovery) was requested from all stakeholders in the 3 month follow-up questionnaire. Whether employees felt that they had been taken seriously by the OP and the RTW coordinator was Maintenance 123 216 Fig. 1 continued J Occup Rehabil (2009) 19:212–222 Matrix: solutions for RTW Obstacle High workload Solution Remark Priority 2 3. +++ +++ +++ 1 +++ +++ ++ 2 Spread of workload over employees in department +/- + + 4 Training in delegation of tasks +++ + ++ 3 Job description for clarity about responsibilities Mr. B Extra meetings with Ms. T about planning Difficulties with delegation of tasks Assessment of criteria 1. Daily meetings Criteria: 1: solution exists and can be realized in the short term 2: solution is inexpensive and can be purchased in this framework 3: solution helps in eliminating/decreasing obstacle for RTW Meaning of plus and minus signs: = a negative score on this criterion + = positive score on this criterion (may vary from + to +++ ) +/- = has both positive and negative aspects ? = unknown Matrix: realization of solutions Obstacle Solution High workload Difficulties with delegation of tasks Person responsible When Done Clarity about Write job description responsibilities Mr. B Ms. T 10-10-2007 dd-mm-yyyy 2 daily meetings (5 minutes) about planning Schedule appointment in the morning and afternoon Mr. B and Ms. T From start RTW dd-mm-yyyy Spread of workload over employees in department Consideration of new schedules for next year Ms. T November 2007 dd-mm-yyyy Training in delegation of tasks Contact with company social worker to plan training Mr. B This week dd- … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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