Supporting workers with musculoskeletal conditions: a survey of United Kingdom occupational therapists' communications with clients and their employers

Introduction: Musculoskeletal conditions are a common cause of sickness absence and work disability. Little is known about the work-related advice and support that occupational therapists provide to this client group and their employers. The purpose of this study was to report on current occupational therapy practice in this area in the United Kingdom. Method: A questionnaire survey was conducted, of United Kingdom occupational therapists treating employed clients with musculoskeletal conditions in community or outpatient settings. Questionnaires were posted to 960 hospitals or units,identified through National Health Service websites to reach as many respondents as possible, and the survey was also available online. Findings: 257 respondents reported on their provision of work-related advice and support. Of these, over 30% (n = 82) reported that this involved a moderate amount of their time; 60% (n = 154) had experience of contacting employers and 21% (n = 55) had met with clients’ employers in the previous year. Time and resources, concern about legal implications, and having the appropriate skills had an impact on communication between therapists and employers. Conclusion: The findings demonstrate considerable variations in service delivery, interventions, and the contact made with employers. These need urgent attention if the profession is to meet the challenges of the government’s agenda for improving health at work

Work Outcomes in Patients Who Stay at Work Despite Musculoskeletal Pain

Purpose: To assess self-reported work impacts and associations between psychosocial risk factors and work impairment amongst workers seeking care for musculoskeletal pain while continuing to work. Methods: Patients were recruited from Musculoskeletal Assessment Clinics at 5 hospitals across Ireland. Participants completed questionnaires including assessments of work impairment (Work Productivity and Activity Impairment Questionnaire), work ability (single item from the Work Ability Index) and work performance (Work Role Functioning Questionnaire; WRFQ). Logistic and hierarchical regressions were conducted to analyse the relation between psychosocial variables and work outcomes. Results: 155 participants (53.5% female; mean age = 46.50 years) who were working at the time of assessment completed the questionnaires. Absenteeism was low, yet 62.6% were classified as functioning poorly according to the WRFQ; 52.3% reported having poor work ability. Logistic regression analyses indicated that higher work role functioning was associated with higher pain self-efficacy (OR 1.51); better work ability was associated with older age (OR 1.063) and lower functional restriction (OR 0.93); greater absenteeism was associated with lower pain self-efficacy (OR 0.65) and poorer work expectancy (OR 1.18). Multiple regression analysis indicated that greater presenteeism was associated with higher pain intensity (β = 0.259) and lower pain self-efficacy (β = − 0.385). Conclusions: While individuals continue to work with musculoskeletal pain, their work performance can be adversely affected. Interventions that target mutable factors, such as pain self-efficacy, may help reduce the likelihood of work impairment